Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.58 / $12.52 / $38.26	Facility	26	$6.58	$12.52	$38.26
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $12.55 / $34.64 / $53.64	Facility	TC	$12.55	$34.64	$53.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.38 / $23.58 / $58.21	Professional		$18.38	$23.58	$58.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.42 / $7.24 / $40.00	Professional	26	$6.42	$7.24	$40.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $11.97 / $14.78 / $26.68	Professional	TC	$11.97	$14.78	$26.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.40 / $23.07 / $23.74	Facility	26	$22.40	$23.07	$23.74
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $51.66 / $53.21 / $54.76	Facility	TC	$51.66	$53.21	$54.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.32 / $49.64 / $62.98	Professional		$23.32	$49.64	$62.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.85 / $16.29 / $22.82	Professional	26	$7.85	$16.29	$22.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.16 / $33.36 / $42.72	Professional	TC	$15.16	$33.36	$42.72
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $33.11 / $73.81	Professional		$19.05	$33.11	$73.81
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.85 / $11.17 / $29.79	Professional	26	$6.85	$11.17	$29.79
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $12.21 / $21.07 / $39.99	Professional	TC	$12.21	$21.07	$39.99
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $23.07 / $100.00 / $100.00	Facility	26	$23.07	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $53.21 / $100.00 / $100.00	Facility	TC	$53.21	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $21.77 / $38.19 / $172.00	Professional		$21.77	$38.19	$172.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $7.55 / $9.81 / $72.64	Professional	26	$7.55	$9.81	$72.64
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $13.49 / $18.28 / $148.00	Professional	TC	$13.49	$18.28	$148.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $23.07 / $23.74 / $40.86	Facility	26	$23.07	$23.74	$40.86
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $53.21 / $54.76 / $76.26	Facility	TC	$53.21	$54.76	$76.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $40.21 / $46.27 / $73.61	Professional		$40.21	$46.27	$73.61
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $7.42 / $14.87 / $36.15	Professional		$7.42	$14.87	$36.15
United Facility/Professional Professional Modifier Low / Median / High Price $20.57 / $25.77 / $42.45	Professional		$20.57	$25.77	$42.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.55 / $9.52 / $16.48	Professional	26	$7.55	$9.52	$16.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.02 / $15.96 / $28.52	Professional	TC	$13.02	$15.96	$28.52
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $29.31 / $37.10 / $43.70	Professional		$29.31	$37.10	$43.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $9.94 / $12.60 / $14.80	Professional	26	$9.94	$12.60	$14.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $19.43 / $24.60 / $28.90	Professional	TC	$19.43	$24.60	$28.90