Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.18 / $20.69 / $53.99	Facility	26	$11.18	$20.69	$53.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.61 / $42.37 / $208.00	Professional		$33.61	$42.37	$208.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.44 / $11.66 / $50.46	Professional	26	$10.44	$11.66	$50.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.13 / $30.09 / $56.30	Professional	TC	$25.13	$30.09	$56.30
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.58 / $35.61 / $36.65	Facility	26	$34.58	$35.61	$36.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.33 / $97.74 / $122.17	Professional		$42.33	$97.74	$122.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.98 / $27.15 / $35.43	Professional	26	$11.98	$27.15	$35.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.64 / $70.59 / $88.24	Professional	TC	$29.64	$70.59	$88.24
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $36.76 / $57.85 / $121.81	Professional		$36.76	$57.85	$121.81
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $17.22 / $39.00	Professional	26	$11.22	$17.22	$39.00
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.54 / $40.13 / $71.81	Professional	TC	$25.54	$40.13	$71.81
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $35.61 / $100.00 / $100.00	Facility	26	$35.61	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $37.81 / $62.01 / $271.52	Professional		$37.81	$62.01	$271.52
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.71 / $16.22 / $97.41	Professional	26	$11.71	$16.22	$97.41
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.36 / $33.78 / $210.00	Professional	TC	$25.36	$33.78	$210.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $35.61 / $36.65 / $67.73	Facility	26	$35.61	$36.65	$67.73
Midlands Facility/Professional Professional Modifier Low / Median / High Price $64.00 / $85.37 / $128.27	Professional		$64.00	$85.37	$128.27
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $12.41 / $37.61 / $73.17	Professional		$12.41	$37.61	$73.17
United Facility/Professional Professional Modifier Low / Median / High Price $37.81 / $49.24 / $104.97	Professional		$37.81	$49.24	$104.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.83 / $15.39 / $26.38	Professional	26	$11.83	$15.39	$26.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.36 / $33.02 / $55.23	Professional	TC	$25.36	$33.02	$55.23
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $56.80 / $71.90 / $84.60	Professional		$56.80	$71.90	$84.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $16.27 / $20.60 / $24.20	Professional	26	$16.27	$20.60	$24.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $40.61 / $51.40 / $60.50	Professional	TC	$40.61	$51.40	$60.50