Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.09 / $13.10 / $39.40	Facility	26	$7.09	$13.10	$39.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.87 / $30.06 / $116.06	Professional		$17.87	$30.06	$116.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.90 / $7.57 / $35.00	Professional	26	$6.90	$7.57	$35.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.54 / $60.12 / $60.12	Professional	50	$38.54	$60.12	$60.12
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.52 / $13.32 / $21.56	Professional	52	$11.52	$13.32	$21.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.92 / $21.52 / $51.04	Professional	TC	$17.92	$21.52	$51.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.12 / $24.84 / $25.57	Facility	26	$24.12	$24.84	$25.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.68 / $65.93 / $82.42	Professional		$28.68	$65.93	$82.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.21 / $17.07 / $21.99	Professional	26	$8.21	$17.07	$21.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.47 / $48.87 / $61.09	Professional	TC	$20.47	$48.87	$61.09
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $24.77 / $39.93 / $75.34	Professional		$24.77	$39.93	$75.34
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.17 / $11.72 / $27.14	Professional	26	$7.17	$11.72	$27.14
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.60 / $27.70 / $47.50	Professional	TC	$17.60	$27.70	$47.50
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $24.84 / $100.00 / $100.00	Facility	26	$24.84	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.22 / $44.57 / $184.96	Professional		$26.22	$44.57	$184.96
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $7.93 / $10.27 / $67.13	Professional	26	$7.93	$10.27	$67.13
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $18.16 / $24.25 / $149.00	Professional	TC	$18.16	$24.25	$149.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $24.84 / $25.57 / $42.84	Facility	26	$24.84	$25.57	$42.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $58.30 / $91.07	Professional		$45.00	$58.30	$91.07
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $7.85 / $25.26 / $47.87	Professional		$7.85	$25.26	$47.87
United Facility/Professional Professional Modifier Low / Median / High Price $26.05 / $33.92 / $53.38	Professional		$26.05	$33.92	$53.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.89 / $9.86 / $16.55	Professional	26	$7.89	$9.86	$16.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.16 / $22.02 / $36.96	Professional	TC	$18.16	$22.02	$36.96
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $38.32 / $48.50 / $57.10	Professional		$38.32	$48.50	$57.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $10.35 / $13.10 / $15.40	Professional	26	$10.35	$13.10	$15.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $27.97 / $35.40 / $41.60	Professional	TC	$27.97	$35.40	$41.60