Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.19 / $17.19 / $56.46	Facility	26	$17.19	$17.19	$56.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.50 / $36.68 / $165.00	Professional		$29.50	$36.68	$165.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.02 / $10.02 / $25.37	Professional	26	$9.02	$10.02	$25.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.74 / $24.43 / $46.22	Professional	TC	$20.74	$24.43	$46.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.64 / $35.68 / $36.72	Facility	26	$34.64	$35.68	$36.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.14 / $80.67 / $113.37	Professional		$35.14	$80.67	$113.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.66 / $22.79 / $32.00	Professional	26	$10.66	$22.79	$32.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.40 / $58.18 / $79.31	Professional	TC	$24.40	$58.18	$79.31
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $30.36 / $51.17 / $115.53	Professional		$30.36	$51.17	$115.53
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.36 / $15.21 / $36.49	Professional	26	$9.36	$15.21	$36.49
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.00 / $34.11 / $64.09	Professional	TC	$21.00	$34.11	$64.09
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $35.68 / $100.00 / $100.00	Facility	26	$35.68	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.75 / $56.00 / $223.92	Professional		$33.75	$56.00	$223.92
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.74 / $13.91 / $92.47	Professional	26	$10.74	$13.91	$92.47
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.09 / $28.42 / $211.00	Professional	TC	$22.09	$28.42	$211.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $35.68 / $36.72 / $56.28	Facility	26	$35.68	$36.72	$56.28
Midlands Facility/Professional Professional Modifier Low / Median / High Price $58.44 / $74.01 / $117.74	Professional		$58.44	$74.01	$117.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.06 / $25.98 / $58.98	Professional		$10.06	$25.98	$58.98
United Facility/Professional Professional Modifier Low / Median / High Price $31.78 / $41.38 / $68.17	Professional		$31.78	$41.38	$68.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.68 / $13.70 / $22.64	Professional	26	$10.68	$13.70	$22.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.09 / $27.47 / $46.26	Professional	TC	$22.09	$27.47	$46.26
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $46.93 / $59.40 / $69.90	Professional		$46.93	$59.40	$69.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $13.51 / $17.10 / $20.20	Professional	26	$13.51	$17.10	$20.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $33.34 / $42.20 / $49.70	Professional	TC	$33.34	$42.20	$49.70