Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.91 / $18.32 / $56.46	Facility	26	$9.91	$18.32	$56.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.77 / $46.61 / $203.17	Professional		$34.77	$46.61	$203.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.60 / $10.58 / $24.00	Professional	26	$9.60	$10.58	$24.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.42 / $36.57 / $60.00	Professional	TC	$25.42	$36.57	$60.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.74 / $37.84 / $38.94	Facility	26	$36.74	$37.84	$38.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.09 / $94.64 / $118.29	Professional		$48.09	$94.64	$118.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.34 / $24.05 / $33.44	Professional	26	$11.34	$24.05	$33.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.07 / $70.59 / $88.24	Professional	TC	$35.07	$70.59	$88.24
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $35.51 / $61.35 / $133.12	Professional		$35.51	$61.35	$133.12
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.96 / $16.14 / $39.00	Professional	26	$9.96	$16.14	$39.00
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.54 / $43.61 / $93.24	Professional	TC	$25.54	$43.61	$93.24
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $37.84 / $100.00 / $100.00	Facility	26	$37.84	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.39 / $69.00 / $262.94	Professional		$40.39	$69.00	$262.94
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.04 / $14.38 / $117.24	Professional	26	$11.04	$14.38	$117.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.25 / $38.52 / $201.73	Professional	TC	$28.25	$38.52	$201.73
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $37.84 / $38.94 / $60.06	Facility	26	$37.84	$38.94	$60.06
Midlands Facility/Professional Professional Modifier Low / Median / High Price $75.87 / $86.81 / $138.11	Professional		$75.87	$86.81	$138.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $32.49 / $70.45	Professional		$10.72	$32.49	$70.45
United Facility/Professional Professional Modifier Low / Median / High Price $36.72 / $47.82 / $79.73	Professional		$36.72	$47.82	$79.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.04 / $14.08 / $31.96	Professional	26	$11.04	$14.08	$31.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.08 / $33.44 / $56.34	Professional	TC	$27.08	$33.44	$56.34
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $55.06 / $69.70 / $81.90	Professional		$55.06	$69.70	$81.90
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 $40.61 / $51.40 / $60.50	Professional	TC	$40.61	$51.40	$60.50