Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $15.85 / $18.62	Facility	26	$7.94	$15.85	$18.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $39.81 / $181.97	Professional		$22.91	$39.81	$181.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $12.02 / $43.65	Professional	26	$7.08	$12.02	$43.65
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $30.20 / $33.88 / $158.49	Professional	52	$30.20	$33.88	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $22.91 / $123.03	Professional	TC	$15.14	$22.91	$123.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $36.31 / $37.15	Facility	26	$34.67	$36.31	$37.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $67.61 / $85.11	Professional		$39.81	$67.61	$85.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $20.42 / $27.54	Professional	26	$11.75	$20.42	$27.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $47.86 / $58.88	Professional	TC	$28.18	$47.86	$58.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $47.86 / $128.82	Professional		$26.30	$47.86	$128.82
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $15.14 / $37.15	Professional	26	$8.32	$15.14	$37.15
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $31.62 / $97.72	Professional	TC	$17.78	$31.62	$97.72
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $100.00 / $100.00	Facility	26	$36.31	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $57.54 / $213.80	Professional		$32.36	$57.54	$213.80
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $13.80 / $79.43	Professional	26	$9.77	$13.80	$79.43
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $30.90 / $204.17	Professional	TC	$21.88	$30.90	$204.17
Midlands Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $72.44 / $83.18	Professional		$56.23	$72.44	$83.18
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $20.89 / $28.18	Professional	26	$18.20	$20.89	$28.18
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $48.98 / $57.54	Professional	TC	$38.02	$48.98	$57.54
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $37.15 / $37.15	Facility	26	$37.15	$37.15	$37.15
Midlands Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $69.18 / $83.18	Professional		$67.61	$69.18	$83.18
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $21.38 / $28.84	Professional	26	$20.89	$21.38	$28.84
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $46.77 / $61.66	Professional	TC	$46.77	$46.77	$61.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $21.88 / $51.29	Professional		$9.77	$21.88	$51.29
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $38.02 / $72.44	Professional		$28.84	$38.02	$72.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $11.75 / $21.88	Professional	26	$9.33	$11.75	$21.88
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 $50.12 / $50.12 / $58.88	Professional		$50.12	$50.12	$58.88
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $15.49 / $18.20	Professional	26	$15.49	$15.49	$18.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $34.67 / $40.74	Professional	TC	$34.67	$34.67	$40.74