Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.69 / $33.29 / $61.57	Facility	26	$20.69	$33.29	$61.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.99 / $42.27 / $85.21	Professional		$37.99	$42.27	$85.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.41 / $10.95 / $23.41	Professional	26	$9.41	$10.95	$23.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.37 / $31.15 / $47.59	Professional	TC	$27.37	$31.15	$47.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.54 / $33.53 / $34.50	Facility	26	$32.54	$33.53	$34.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $103.94 / $129.93	Professional		$45.00	$103.94	$129.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.01 / $26.37 / $34.92	Professional	26	$12.01	$26.37	$34.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.59 / $77.56 / $96.96	Professional	TC	$32.59	$77.56	$96.96
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $39.03 / $65.97 / $129.32	Professional		$39.03	$65.97	$129.32
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.94 / $16.79 / $37.74	Professional	26	$10.94	$16.79	$37.74
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.10 / $46.51 / $89.50	Professional	TC	$28.10	$46.51	$89.50
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $33.53 / $103.00 / $103.00	Facility	26	$33.53	$103.00	$103.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.14 / $70.00 / $286.68	Professional		$42.14	$70.00	$286.68
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.77 / $15.78 / $107.32	Professional	26	$11.77	$15.78	$107.32
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.49 / $38.26 / $267.00	Professional	TC	$29.49	$38.26	$267.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $33.53 / $34.50 / $65.94	Facility	26	$33.53	$34.50	$65.94
Midlands Facility/Professional Professional Modifier Low / Median / High Price $74.56 / $88.22 / $151.69	Professional		$74.56	$88.22	$151.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.45 / $33.86 / $73.88	Professional		$11.45	$33.86	$73.88
United Facility/Professional Professional Modifier Low / Median / High Price $41.49 / $50.15 / $80.68	Professional		$41.49	$50.15	$80.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.96 / $14.54 / $24.24	Professional	26	$11.96	$14.54	$24.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.98 / $36.44 / $94.58	Professional	TC	$27.98	$36.44	$94.58
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $60.44 / $76.50 / $90.00	Professional		$60.44	$76.50	$90.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $15.80 / $20.00 / $23.50	Professional	26	$15.80	$20.00	$23.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $44.64 / $56.50 / $66.50	Professional	TC	$44.64	$56.50	$66.50