Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $14.45 / $32.36	Facility	26	$12.88	$14.45	$32.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $37.15 / $112.20	Professional		$17.78	$37.15	$112.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $17.78 / $57.54	Professional	26	$10.72	$17.78	$57.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $22.91 / $69.18	Professional	TC	$10.96	$22.91	$69.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.99 / $25.12 / $25.70	Facility	26	$23.99	$25.12	$25.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $102.33 / $128.82	Professional		$32.36	$102.33	$128.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $34.67 / $43.65	Professional	26	$10.96	$34.67	$43.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $67.61 / $85.11	Professional	TC	$18.62	$67.61	$85.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $54.95 / $93.33	Professional		$33.88	$54.95	$93.33
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $19.95 / $51.29	Professional	26	$13.80	$19.95	$51.29
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $31.62 / $42.66	Professional	TC	$21.38	$31.62	$42.66
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $35.48 / $100.00 / $100.00	Facility	26	$35.48	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $47.86 / $741.31	Professional		$22.39	$47.86	$741.31
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $19.50 / $95.50	Professional	26	$8.71	$19.50	$95.50
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $11.48 / $30.90 / $724.44	Professional	TC	$11.48	$30.90	$724.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $83.18 / $104.71	Professional		$37.15	$83.18	$104.71
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $30.20 / $37.15	Professional	26	$18.62	$30.20	$37.15
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $52.48 / $67.61	Professional	TC	$18.20	$52.48	$67.61
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $25.70 / $25.70	Facility	26	$25.70	$25.70	$25.70
Midlands Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $37.15 / $104.71	Professional		$22.91	$37.15	$104.71
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $19.05 / $37.15	Professional	26	$15.49	$19.05	$37.15
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $25.70 / $67.61	Professional	TC	$15.85	$25.70	$67.61
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $32.36 / $74.13	Professional		$15.49	$32.36	$74.13
United Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $45.71 / $81.28	Professional		$21.38	$45.71	$81.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $17.78 / $30.90	Professional	26	$8.71	$17.78	$30.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.48 / $28.18 / $52.48	Professional	TC	$11.48	$28.18	$52.48
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $87.10	Professional		$74.13	$74.13	$87.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $25.70 / $30.20	Professional	26	$25.70	$25.70	$30.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $47.86 / $56.23	Professional	TC	$47.86	$47.86	$56.23