Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.66 / $10.77 / $32.33	Facility	26	$5.66	$10.77	$32.33
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.01 / $60.29 / $117.00	Facility	TC	$24.01	$60.29	$117.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.17 / $32.07 / $137.00	Professional		$23.17	$32.07	$137.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.67 / $6.45 / $27.38	Professional	26	$5.67	$6.45	$27.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.64 / $23.87 / $70.31	Professional	TC	$19.64	$23.87	$70.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.88 / $20.48 / $21.07	Facility	26	$19.88	$20.48	$21.07
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $73.26 / $75.45 / $77.66	Facility	TC	$73.26	$75.45	$77.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.56 / $67.48 / $84.36	Professional		$27.56	$67.48	$84.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.80 / $13.96 / $17.45	Professional	26	$6.80	$13.96	$17.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.56 / $53.52 / $66.90	Professional	TC	$20.56	$53.52	$66.90
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $25.22 / $38.18 / $72.83	Professional		$25.22	$38.18	$72.83
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $5.92 / $9.61 / $22.60	Professional	26	$5.92	$9.61	$22.60
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.30 / $29.20 / $46.05	Professional	TC	$19.30	$29.20	$46.05
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $20.48 / $100.00 / $100.00	Facility	26	$20.48	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $75.45 / $102.96 / $102.96	Facility	TC	$75.45	$102.96	$102.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $25.95 / $42.30 / $187.25	Professional		$25.95	$42.30	$187.25
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $6.49 / $8.44 / $54.49	Professional	26	$6.49	$8.44	$54.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.47 / $25.98 / $146.99	Professional	TC	$19.47	$25.98	$146.99
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $20.48 / $21.07 / $35.15	Facility	26	$20.48	$21.07	$35.15
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $75.45 / $77.66 / $123.12	Facility	TC	$75.45	$77.66	$123.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $41.00 / $59.16 / $79.54	Professional		$41.00	$59.16	$79.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $6.55 / $25.76 / $49.09	Professional		$6.55	$25.76	$49.09
United Facility/Professional Professional Modifier Low / Median / High Price $25.95 / $33.09 / $55.78	Professional		$25.95	$33.09	$55.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.48 / $8.16 / $13.59	Professional	26	$6.48	$8.16	$13.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.47 / $25.35 / $42.19	Professional	TC	$19.47	$25.35	$42.19
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 $8.52 / $10.80 / $12.80	Professional	26	$8.52	$10.80	$12.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $30.65 / $38.79 / $45.70	Professional	TC	$30.65	$38.79	$45.70