Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $10.23 / $20.89	Facility	26	$8.91	$10.23	$20.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $54.95 / $234.42	Professional		$32.36	$54.95	$234.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $14.79 / $53.70	Professional	26	$8.91	$14.79	$53.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $36.31 / $162.18	Professional	TC	$23.99	$36.31	$162.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $38.02 / $38.90	Facility	26	$37.15	$38.02	$38.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $97.72 / $120.23	Professional		$54.95	$97.72	$120.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $24.55 / $30.90	Professional	26	$13.49	$24.55	$30.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $72.44 / $91.20	Professional	TC	$39.81	$72.44	$91.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $61.66 / $169.82	Professional		$36.31	$61.66	$169.82
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $16.22 / $47.86	Professional	26	$10.00	$16.22	$47.86
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $45.71 / $128.82	Professional	TC	$26.92	$45.71	$128.82
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $38.02 / $100.00 / $100.00	Facility	26	$38.02	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $74.13 / $263.03	Professional		$40.74	$74.13	$263.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $16.60 / $117.49	Professional	26	$10.96	$16.60	$117.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $40.74 / $199.53	Professional	TC	$28.18	$40.74	$199.53
Midlands Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $95.50 / $117.49	Professional		$79.43	$95.50	$117.49
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $26.30 / $35.48	Professional	26	$21.38	$26.30	$35.48
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $74.13 / $81.28	Professional	TC	$57.54	$74.13	$81.28
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $38.90 / $38.90	Facility	26	$38.90	$38.90	$38.90
Midlands Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $87.10 / $102.33	Professional		$77.62	$87.10	$102.33
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $23.44 / $26.30	Professional	26	$22.39	$23.44	$26.30
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $63.10 / $74.13	Professional	TC	$54.95	$63.10	$74.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $32.36 / $70.79	Professional		$10.96	$32.36	$70.79
United Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $47.86 / $89.13	Professional		$38.02	$47.86	$89.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $13.80 / $25.70	Professional	26	$10.96	$13.80	$25.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $33.88 / $61.66	Professional	TC	$26.92	$33.88	$61.66
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $81.28	Professional		$69.18	$69.18	$81.28
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $18.20 / $21.38	Professional	26	$18.20	$18.20	$21.38
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $51.29 / $60.26	Professional	TC	$51.29	$51.29	$60.26