Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.86 / $25.63 / $39.40	Facility	26	$13.86	$25.63	$39.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.27 / $36.57 / $107.00	Professional		$17.27	$36.57	$107.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.48 / $14.65 / $48.00	Professional	26	$7.48	$14.65	$48.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $11.48 / $23.08 / $36.88	Professional	TC	$11.48	$23.08	$36.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.21 / $24.94 / $25.66	Facility	26	$24.21	$24.94	$25.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.68 / $91.81 / $125.08	Professional		$28.68	$91.81	$125.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.80 / $32.03 / $42.66	Professional	26	$10.80	$32.03	$42.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.82 / $58.82 / $82.42	Professional	TC	$17.82	$58.82	$82.42
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $33.75 / $42.38 / $74.75	Professional		$33.75	$42.38	$74.75
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.87 / $15.31 / $31.49	Professional	26	$13.87	$15.31	$31.49
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.82 / $27.13 / $42.18	Professional	TC	$19.82	$27.13	$42.18
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $35.32 / $100.00 / $100.00	Facility	26	$35.32	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $23.53 / $52.24 / $738.38	Professional		$23.53	$52.24	$738.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.93 / $19.66 / $95.54	Professional	26	$8.93	$19.66	$95.54
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $13.72 / $32.15 / $724.28	Professional	TC	$13.72	$32.15	$724.28
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $24.94 / $25.66 / $83.70	Facility	26	$24.94	$25.66	$83.70
Midlands Facility/Professional Professional Modifier Low / Median / High Price $31.83 / $79.66 / $104.49	Professional		$31.83	$79.66	$104.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.17 / $38.53 / $72.94	Professional		$15.17	$38.53	$72.94
United Facility/Professional Professional Modifier Low / Median / High Price $22.68 / $48.14 / $79.51	Professional		$22.68	$48.14	$79.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.10 / $18.50 / $29.76	Professional	26	$10.10	$18.50	$29.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.41 / $29.64 / $50.32	Professional	TC	$14.41	$29.64	$50.32
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $58.22 / $73.70 / $86.60	Professional		$58.22	$73.70	$86.60
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 $37.92 / $48.00 / $56.40	Professional	TC	$37.92	$48.00	$56.40