Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.76 / $26.21 / $78.12	Facility	26	$22.76	$26.21	$78.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.38 / $48.42 / $237.94	Professional		$42.38	$48.42	$237.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.58 / $15.66 / $39.70	Professional	26	$13.58	$15.66	$39.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.22 / $34.03 / $65.13	Professional	TC	$29.22	$34.03	$65.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.61 / $48.01 / $49.41	Facility	26	$46.61	$48.01	$49.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.63 / $117.13 / $146.41	Professional		$50.63	$117.13	$146.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.41 / $34.90 / $45.73	Professional	26	$16.41	$34.90	$45.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.99 / $82.22 / $102.78	Professional	TC	$33.99	$82.22	$102.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $43.86 / $71.34 / $129.35	Professional		$43.86	$71.34	$129.35
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.35 / $23.26 / $51.00	Professional	26	$14.35	$23.26	$51.00
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $44.78 / $77.06	Professional	TC	$29.51	$44.78	$77.06
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $48.01 / $100.00 / $100.00	Facility	26	$48.01	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $46.52 / $74.66 / $321.19	Professional		$46.52	$74.66	$321.19
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.64 / $20.35 / $128.79	Professional	26	$15.64	$20.35	$128.79
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.61 / $39.40 / $254.00	Professional	TC	$29.61	$39.40	$254.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $48.01 / $49.41 / $83.88	Facility	26	$48.01	$49.41	$83.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $77.00 / $98.51 / $155.21	Professional		$77.00	$98.51	$155.21
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.50 / $44.76 / $83.32	Professional		$15.50	$44.76	$83.32
United Facility/Professional Professional Modifier Low / Median / High Price $45.24 / $54.29 / $94.48	Professional		$45.24	$54.29	$94.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.64 / $19.38 / $33.10	Professional	26	$15.64	$19.38	$33.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.61 / $38.56 / $72.66	Professional	TC	$29.61	$38.56	$72.66
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $67.62 / $85.60 / $100.80	Professional		$67.62	$85.60	$100.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $20.78 / $26.30 / $30.90	Professional	26	$20.78	$26.30	$30.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $46.93 / $59.40 / $69.90	Professional	TC	$46.93	$59.40	$69.90