Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.21 / $14.21 / $45.15	Facility	26	$14.21	$14.21	$45.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.52 / $37.53 / $163.00	Professional		$30.52	$37.53	$163.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.48 / $8.90 / $20.91	Professional	26	$7.48	$8.90	$20.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.26 / $27.71 / $62.99	Professional	TC	$22.26	$27.71	$62.99
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.18 / $31.09 / $31.99	Facility	26	$30.18	$31.09	$31.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.72 / $93.08 / $116.36	Professional		$32.72	$93.08	$116.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.86 / $18.62 / $24.93	Professional	26	$8.86	$18.62	$24.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.70 / $67.61 / $93.08	Professional	TC	$24.70	$67.61	$93.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $34.70 / $52.07 / $94.18	Professional		$34.70	$52.07	$94.18
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.74 / $12.69 / $23.04	Professional	26	$7.74	$12.69	$23.04
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.96 / $36.58 / $68.04	Professional	TC	$26.96	$36.58	$68.04
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $31.09 / $100.00 / $100.00	Facility	26	$31.09	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.61 / $55.08 / $260.95	Professional		$35.61	$55.08	$260.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.64 / $11.13 / $83.63	Professional	26	$8.64	$11.13	$83.63
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.74 / $36.38 / $207.72	Professional	TC	$25.74	$36.38	$207.72
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $31.09 / $31.99 / $44.64	Facility	26	$31.09	$31.99	$44.64
Midlands Facility/Professional Professional Modifier Low / Median / High Price $48.00 / $77.55 / $99.68	Professional		$48.00	$77.55	$99.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.43 / $34.89 / $70.19	Professional		$8.43	$34.89	$70.19
United Facility/Professional Professional Modifier Low / Median / High Price $34.08 / $43.04 / $72.47	Professional		$34.08	$43.04	$72.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.55 / $11.13 / $19.80	Professional	26	$8.55	$11.13	$19.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.95 / $35.58 / $61.46	Professional	TC	$25.95	$35.58	$61.46
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $54.12 / $68.50 / $80.59	Professional		$54.12	$68.50	$80.59
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $11.30 / $14.30 / $16.80	Professional	26	$11.30	$14.30	$16.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $42.82 / $54.20 / $63.80	Professional	TC	$42.82	$54.20	$63.80