Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.71 / $13.71 / $42.83	Facility	26	$13.71	$13.71	$42.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.78 / $30.72 / $145.28	Professional		$26.78	$30.72	$145.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.00 / $7.78 / $17.98	Professional	26	$7.00	$7.78	$17.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.46 / $22.09 / $41.04	Professional	TC	$19.46	$22.09	$41.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.12 / $26.90 / $27.69	Facility	26	$26.12	$26.90	$27.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.29 / $78.34 / $97.93	Professional		$33.29	$78.34	$97.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.89 / $18.62 / $25.89	Professional	26	$8.89	$18.62	$25.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.32 / $59.19 / $74.66	Professional	TC	$23.32	$59.19	$74.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $29.35 / $45.83 / $98.80	Professional		$29.35	$45.83	$98.80
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $12.72 / $25.16	Professional	26	$7.78	$12.72	$25.16
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.57 / $32.43 / $58.66	Professional	TC	$21.57	$32.43	$58.66
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $26.90 / $100.00 / $100.00	Facility	26	$26.90	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $29.68 / $48.67 / $210.99	Professional		$29.68	$48.67	$210.99
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.64 / $11.17 / $82.56	Professional	26	$8.64	$11.17	$82.56
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.65 / $27.87 / $159.97	Professional	TC	$20.65	$27.87	$159.97
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $26.90 / $27.69 / $44.82	Facility	26	$26.90	$27.69	$44.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $49.00 / $64.75 / $100.05	Professional		$49.00	$64.75	$100.05
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.41 / $26.32 / $56.64	Professional		$8.41	$26.32	$56.64
United Facility/Professional Professional Modifier Low / Median / High Price $29.68 / $36.90 / $60.19	Professional		$29.68	$36.90	$60.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.58 / $10.83 / $18.00	Professional	26	$8.58	$10.83	$18.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.10 / $26.90 / $45.94	Professional	TC	$21.10	$26.90	$45.94
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $45.58 / $57.70 / $67.80	Professional		$45.58	$57.70	$67.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $11.30 / $14.30 / $16.80	Professional	26	$11.30	$14.30	$16.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $34.29 / $43.40 / $51.00	Professional	TC	$34.29	$43.40	$51.00