Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.37 / $34.85 / $64.17	Facility	26	$16.37	$34.85	$64.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.31 / $37.67 / $79.27	Professional		$35.31	$37.67	$79.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.05 / $9.98 / $21.30	Professional	26	$9.05	$9.98	$21.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.25 / $27.69 / $45.16	Professional	TC	$24.25	$27.69	$45.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.72 / $33.71 / $34.69	Facility	26	$32.72	$33.71	$34.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.31 / $95.41 / $119.26	Professional		$41.31	$95.41	$119.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.01 / $23.27 / $32.36	Professional	26	$11.01	$23.27	$32.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.29 / $71.98 / $90.18	Professional	TC	$30.29	$71.98	$90.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $35.79 / $56.80 / $111.77	Professional		$35.79	$56.80	$111.77
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.68 / $15.71 / $32.71	Professional	26	$9.68	$15.71	$32.71
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.11 / $40.94 / $73.61	Professional	TC	$26.11	$40.94	$73.61
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $33.71 / $100.00 / $100.00	Facility	26	$33.71	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $37.04 / $62.75 / $267.27	Professional		$37.04	$62.75	$267.27
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.04 / $14.38 / $85.85	Professional	26	$11.04	$14.38	$85.85
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.01 / $34.36 / $244.00	Professional	TC	$26.01	$34.36	$244.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $33.71 / $34.69 / $58.26	Facility	26	$33.71	$34.69	$58.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $64.63 / $80.50 / $134.66	Professional		$64.63	$80.50	$134.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.45 / $36.65 / $69.37	Professional		$10.45	$36.65	$69.37
United Facility/Professional Professional Modifier Low / Median / High Price $37.04 / $47.25 / $74.54	Professional		$37.04	$47.25	$74.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.04 / $13.25 / $22.47	Professional	26	$11.04	$13.25	$22.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.01 / $32.50 / $52.98	Professional	TC	$26.01	$32.50	$52.98
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $55.46 / $70.20 / $82.60	Professional		$55.46	$70.20	$82.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $13.98 / $17.70 / $20.80	Professional	26	$13.98	$17.70	$20.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $41.48 / $52.50 / $61.80	Professional	TC	$41.48	$52.50	$61.80