Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.17 / $48.53 / $89.84	Facility	26	$31.17	$48.53	$89.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.77 / $43.17 / $72.19	Professional		$34.77	$43.17	$72.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.86 / $14.43 / $24.96	Professional	26	$12.86	$14.43	$24.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.91 / $26.30 / $51.77	Professional	TC	$21.91	$26.30	$51.77
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 $43.09 / $96.19 / $133.78	Professional		$43.09	$96.19	$133.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.07 / $34.13 / $49.00	Professional	26	$16.07	$34.13	$49.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.59 / $62.06 / $91.12	Professional	TC	$30.59	$62.06	$91.12
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $36.47 / $67.11 / $174.56	Professional		$36.47	$67.11	$174.56
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.06 / $22.94 / $70.45	Professional	26	$14.06	$22.94	$70.45
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.42 / $41.96 / $108.94	Professional	TC	$22.42	$41.96	$108.94
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 $41.48 / $74.47 / $390.88	Professional		$41.48	$74.47	$390.88
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.86 / $20.36 / $103.00	Professional	26	$15.86	$20.36	$103.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.31 / $36.21 / $301.75	Professional	TC	$23.31	$36.21	$301.75
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 $72.80 / $88.24 / $140.38	Professional		$72.80	$88.24	$140.38
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.73 / $36.45 / $72.01	Professional		$15.73	$36.45	$72.01
United Facility/Professional Professional Modifier Low / Median / High Price $37.71 / $49.11 / $79.30	Professional		$37.71	$49.11	$79.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.63 / $19.48 / $31.45	Professional	26	$15.63	$19.48	$31.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.08 / $27.61 / $48.42	Professional	TC	$22.08	$27.61	$48.42
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $55.93 / $70.80 / $83.30	Professional		$55.93	$70.80	$83.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $20.30 / $25.70 / $30.20	Professional	26	$20.30	$25.70	$30.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $35.63 / $45.10 / $53.10	Professional	TC	$35.63	$45.10	$53.10