Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.67 / $18.39 / $53.54	Facility	26	$9.67	$18.39	$53.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.17 / $39.53 / $190.00	Professional		$34.17	$39.53	$190.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.41 / $10.63 / $25.05	Professional	26	$9.41	$10.63	$25.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.52 / $28.18 / $59.09	Professional	TC	$24.52	$28.18	$59.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.95 / $32.90 / $33.86	Facility	26	$31.95	$32.90	$33.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.70 / $91.53 / $114.42	Professional		$39.70	$91.53	$114.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.37 / $24.05 / $33.44	Professional	26	$11.37	$24.05	$33.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.33 / $67.48 / $84.36	Professional	TC	$28.33	$67.48	$84.36
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $34.40 / $58.08 / $125.62	Professional		$34.40	$58.08	$125.62
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $16.14 / $37.20	Professional	26	$10.00	$16.14	$37.20
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $24.41 / $38.85 / $75.48	Professional	TC	$24.41	$38.85	$75.48
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $32.90 / $100.00 / $100.00	Facility	26	$32.90	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $36.69 / $61.90 / $252.05	Professional		$36.69	$61.90	$252.05
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.40 / $14.85 / $92.47	Professional	26	$11.40	$14.85	$92.47
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.03 / $32.47 / $226.00	Professional	TC	$25.03	$32.47	$226.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $32.90 / $33.86 / $60.18	Facility	26	$32.90	$33.86	$60.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $65.81 / $77.34 / $133.60	Professional		$65.81	$77.34	$133.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.48 / $29.41 / $65.06	Professional		$10.48	$29.41	$65.06
United Facility/Professional Professional Modifier Low / Median / High Price $35.78 / $46.59 / $71.87	Professional		$35.78	$46.59	$71.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.40 / $14.85 / $24.45	Professional	26	$11.40	$14.85	$24.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.38 / $30.48 / $49.65	Professional	TC	$24.38	$30.48	$49.65
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $53.25 / $67.40 / $79.30	Professional		$53.25	$67.40	$79.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $14.46 / $18.30 / $21.50	Professional	26	$14.46	$18.30	$21.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $38.79 / $49.10 / $57.80	Professional	TC	$38.79	$49.10	$57.80