Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.33 / $13.66 / $41.68	Facility	26	$7.33	$13.66	$41.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.12 / $33.90 / $118.74	Professional		$20.12	$33.90	$118.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $9.25 / $40.79	Professional	26	$7.03	$9.25	$40.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $22.48 / $51.92	Professional	TC	$18.82	$22.48	$51.92
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.05 / $25.80 / $26.55	Facility	26	$25.05	$25.80	$26.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.47 / $76.02 / $95.02	Professional		$32.47	$76.02	$95.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.52 / $17.84 / $24.81	Professional	26	$8.52	$17.84	$24.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.32 / $58.18 / $72.72	Professional	TC	$23.32	$58.18	$72.72
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $28.46 / $44.51 / $74.59	Professional		$28.46	$44.51	$74.59
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.46 / $11.80 / $27.73	Professional	26	$7.46	$11.80	$27.73
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.00 / $31.58 / $50.41	Professional	TC	$21.00	$31.58	$50.41
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $25.80 / $100.00 / $100.00	Facility	26	$25.80	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.99 / $47.91 / $206.66	Professional		$28.99	$47.91	$206.66
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.23 / $10.70 / $79.26	Professional	26	$8.23	$10.70	$79.26
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.26 / $27.44 / $161.00	Professional	TC	$20.26	$27.44	$161.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $25.80 / $26.55 / $44.64	Facility	26	$25.80	$26.55	$44.64
Midlands Facility/Professional Professional Modifier Low / Median / High Price $47.00 / $63.40 / $97.48	Professional		$47.00	$63.40	$97.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $43.80 / $43.80 / $82.20	Professional		$43.80	$43.80	$82.20
United Facility/Professional Professional Modifier Low / Median / High Price $28.99 / $35.64 / $58.33	Professional		$28.99	$35.64	$58.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.22 / $10.27 / $17.23	Professional	26	$8.22	$10.27	$17.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.77 / $27.05 / $44.70	Professional	TC	$20.77	$27.05	$44.70
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $44.24 / $56.00 / $65.80	Professional		$44.24	$56.00	$65.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $10.82 / $13.70 / $16.10	Professional	26	$10.82	$13.70	$16.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $33.34 / $42.20 / $49.70	Professional	TC	$33.34	$42.20	$49.70