Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $16.60 / $17.38	Facility	26	$7.08	$16.60	$17.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $34.67 / $151.36	Professional		$25.70	$34.67	$151.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $10.00 / $28.84	Professional	26	$6.03	$10.00	$28.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $22.91 / $64.57	Professional	TC	$18.20	$22.91	$64.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.30 / $26.92 / $27.54	Facility	26	$26.30	$26.92	$27.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $79.43 / $100.00	Professional		$38.02	$79.43	$100.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $19.05 / $23.99	Professional	26	$10.47	$19.05	$23.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $61.66 / $75.86	Professional	TC	$27.54	$61.66	$75.86
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $45.71 / $112.20	Professional		$30.20	$45.71	$112.20
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $12.88 / $30.90	Professional	26	$7.76	$12.88	$30.90
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $33.11 / $87.10	Professional	TC	$22.39	$33.11	$87.10
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $100.00 / $100.00	Facility	26	$26.92	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $53.70 / $208.93	Professional		$28.84	$53.70	$208.93
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $12.88 / $83.18	Professional	26	$8.71	$12.88	$83.18
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $31.62 / $158.49	Professional	TC	$19.95	$31.62	$158.49
Midlands Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $72.44 / $85.11	Professional		$58.88	$72.44	$85.11
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $18.62 / $26.30	Professional	26	$16.22	$18.62	$26.30
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $53.70 / $63.10	Professional	TC	$40.74	$53.70	$63.10
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $27.54 / $27.54 / $27.54	Facility	26	$27.54	$27.54	$27.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $60.26 / $83.18	Professional		$54.95	$60.26	$83.18
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $19.50 / $25.12	Professional	26	$16.60	$19.50	$25.12
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $43.65 / $63.10	Professional	TC	$37.15	$43.65	$63.10
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $26.30 / $57.54	Professional		$8.71	$26.30	$57.54
United Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $37.15 / $69.18	Professional		$28.18	$37.15	$69.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $10.47 / $19.50	Professional	26	$8.51	$10.47	$19.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $26.30 / $50.12	Professional	TC	$19.95	$26.30	$50.12
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $67.61	Professional		$57.54	$57.54	$67.61
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $14.45 / $16.98	Professional	26	$14.45	$14.45	$16.98
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $43.65 / $51.29	Professional	TC	$43.65	$43.65	$51.29