Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.80 / $14.80 / $45.15	Facility	26	$14.80	$14.80	$45.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.14 / $30.38 / $153.00	Professional		$20.14	$30.38	$153.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.79 / $8.55 / $39.38	Professional	26	$7.79	$8.55	$39.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.55 / $18.68 / $51.62	Professional	TC	$12.55	$18.68	$51.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.40 / $30.28 / $31.16	Facility	26	$29.40	$30.28	$31.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $55.07 / $81.16	Professional		$28.84	$55.07	$81.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.22 / $19.39 / $26.97	Professional	26	$9.22	$19.39	$26.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.35 / $37.22 / $56.95	Professional	TC	$19.35	$37.22	$56.95
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $21.12 / $36.57 / $91.67	Professional		$21.12	$36.57	$91.67
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.06 / $12.85 / $30.19	Professional	26	$8.06	$12.85	$30.19
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $13.06 / $23.30 / $54.76	Professional	TC	$13.06	$23.30	$54.76
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $30.28 / $100.00 / $100.00	Facility	26	$30.28	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.94 / $44.20 / $203.00	Professional		$26.94	$44.20	$203.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $11.60 / $84.21	Professional	26	$8.91	$11.60	$84.21
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $17.82 / $22.78 / $165.00	Professional	TC	$17.82	$22.78	$165.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $30.28 / $31.16 / $48.42	Facility	26	$30.28	$31.16	$48.42
Midlands Facility/Professional Professional Modifier Low / Median / High Price $44.66 / $57.43 / $81.52	Professional		$44.66	$57.43	$81.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.94 / $21.45 / $42.48	Professional		$8.94	$21.45	$42.48
United Facility/Professional Professional Modifier Low / Median / High Price $25.75 / $33.46 / $59.87	Professional		$25.75	$33.46	$59.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $10.99 / $18.67	Professional	26	$8.91	$10.99	$18.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.84 / $21.93 / $39.22	Professional	TC	$16.84	$21.93	$39.22
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $32.47 / $41.10 / $48.40	Professional		$32.47	$41.10	$48.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $11.69 / $14.80 / $17.50	Professional	26	$11.69	$14.80	$17.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $20.78 / $26.30 / $30.90	Professional	TC	$20.78	$26.30	$30.90