Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.84 / $18.39 / $46.45	Facility	26	$10.84	$18.39	$46.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.42 / $37.56 / $169.86	Professional		$31.42	$37.56	$169.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.73 / $10.37 / $33.29	Professional	26	$8.73	$10.37	$33.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.19 / $26.91 / $61.66	Professional	TC	$23.19	$26.91	$61.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.75 / $28.58 / $29.42	Facility	26	$27.75	$28.58	$29.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.00 / $91.53 / $114.42	Professional		$39.00	$91.53	$114.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.76 / $24.05 / $30.06	Professional	26	$10.76	$24.05	$30.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.23 / $67.48 / $84.36	Professional	TC	$28.23	$67.48	$84.36
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $34.40 / $53.66 / $118.56	Professional		$34.40	$53.66	$118.56
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $15.38 / $26.71	Professional	26	$10.00	$15.38	$26.71
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $24.41 / $37.26 / $67.87	Professional	TC	$24.41	$37.26	$67.87
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $28.58 / $100.00 / $100.00	Facility	26	$28.58	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.45 / $57.78 / $252.05	Professional		$35.45	$57.78	$252.05
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.46 / $14.85 / $97.41	Professional	26	$10.46	$14.85	$97.41
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.05 / $31.88 / $183.85	Professional	TC	$24.05	$31.88	$183.85
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $28.58 / $29.42 / $60.18	Facility	26	$28.58	$29.42	$60.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $58.19 / $76.69 / $118.04	Professional		$58.19	$76.69	$118.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.71 / $35.20 / $65.06	Professional		$10.71	$35.20	$65.06
United Facility/Professional Professional Modifier Low / Median / High Price $35.45 / $45.73 / $71.33	Professional		$35.45	$45.73	$71.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.83 / $13.85 / $22.94	Professional	26	$10.83	$13.85	$22.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.05 / $30.06 / $48.99	Professional	TC	$24.05	$30.06	$48.99
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $53.25 / $67.40 / $79.30	Professional		$53.25	$67.40	$79.30
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 $38.79 / $49.10 / $57.80	Professional	TC	$38.79	$49.10	$57.80