Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.40 / $15.40 / $52.18	Facility	26	$15.40	$15.40	$52.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.23 / $34.52 / $175.62	Professional		$24.23	$34.52	$175.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.88 / $9.44 / $44.00	Professional	26	$7.88	$9.44	$44.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.41 / $13.50 / $20.93	Professional	52	$11.41	$13.50	$20.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.35 / $24.08 / $123.17	Professional	TC	$16.35	$24.08	$123.17
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.94 / $35.99 / $37.04	Facility	26	$34.94	$35.99	$37.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.24 / $66.70 / $103.94	Professional		$35.24	$66.70	$103.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.58 / $20.17 / $28.48	Professional	26	$9.58	$20.17	$28.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.40 / $46.54 / $75.47	Professional	TC	$25.40	$46.54	$75.47
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $25.42 / $44.01 / $101.72	Professional		$25.42	$44.01	$101.72
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.39 / $13.74 / $30.20	Professional	26	$8.39	$13.74	$30.20
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.03 / $29.87 / $66.79	Professional	TC	$17.03	$29.87	$66.79
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $35.99 / $100.00 / $100.00	Facility	26	$35.99	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $31.97 / $54.00 / $216.00	Professional		$31.97	$54.00	$216.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.74 / $12.15 / $79.26	Professional	26	$9.74	$12.15	$79.26
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.77 / $29.06 / $205.00	Professional	TC	$21.77	$29.06	$205.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $35.99 / $37.04 / $50.40	Facility	26	$35.99	$37.04	$50.40
Midlands Facility/Professional Professional Modifier Low / Median / High Price $53.99 / $65.80 / $98.49	Professional		$53.99	$65.80	$98.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.16 / $21.86 / $51.25	Professional		$9.16	$21.86	$51.25
United Facility/Professional Professional Modifier Low / Median / High Price $30.17 / $37.84 / $67.58	Professional		$30.17	$37.84	$67.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.27 / $12.07 / $28.96	Professional	26	$9.27	$12.07	$28.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.78 / $25.77 / $43.40	Professional	TC	$20.78	$25.77	$43.40
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $39.26 / $49.70 / $58.40	Professional		$39.26	$49.70	$58.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $12.17 / $15.40 / $18.10	Professional	26	$12.17	$15.40	$18.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $27.10 / $34.29 / $40.29	Professional	TC	$27.10	$34.29	$40.29