Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.54 / $30.04 / $55.50	Facility	26	$15.54	$30.04	$55.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.01 / $44.75 / $275.00	Professional		$23.01	$44.75	$275.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.02 / $9.94 / $54.34	Professional	26	$9.02	$9.94	$54.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.81 / $26.23 / $119.70	Professional	TC	$13.81	$26.23	$119.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.05 / $31.98 / $32.90	Facility	26	$31.05	$31.98	$32.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.74 / $58.95 / $168.01	Professional		$34.74	$58.95	$168.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.97 / $20.94 / $29.13	Professional	26	$9.97	$20.94	$29.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.31 / $38.01 / $142.38	Professional	TC	$24.31	$38.01	$142.38
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $22.66 / $42.70 / $362.16	Professional		$22.66	$42.70	$362.16
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.75 / $15.71 / $45.11	Professional	26	$8.75	$15.71	$45.11
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $13.91 / $23.88 / $234.47	Professional	TC	$13.91	$23.88	$234.47
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $58.20 / $132.00 / $132.00	Facility	26	$58.20	$132.00	$132.00
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $53.18 / $53.18 / $53.18	Facility	53	$53.18	$53.18	$53.18
Medica Facility/Professional Professional Modifier Low / Median / High Price $23.76 / $48.84 / $761.56	Professional		$23.76	$48.84	$761.56
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.85 / $12.58 / $132.00	Professional	26	$9.85	$12.58	$132.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $13.13 / $23.04 / $705.08	Professional	TC	$13.13	$23.04	$705.08
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $31.98 / $32.90 / $52.50	Facility	26	$31.98	$32.90	$52.50
Midlands Facility/Professional Professional Modifier Low / Median / High Price $45.68 / $54.80 / $152.69	Professional		$45.68	$54.80	$152.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.39 / $23.01 / $43.18	Professional		$9.39	$23.01	$43.18
United Facility/Professional Professional Modifier Low / Median / High Price $22.68 / $28.15 / $79.94	Professional		$22.68	$28.15	$79.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.81 / $12.56 / $22.03	Professional	26	$9.81	$12.56	$22.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.13 / $17.91 / $97.88	Professional	TC	$13.13	$17.91	$97.88
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $34.76 / $44.00 / $51.70	Professional		$34.76	$44.00	$51.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $12.64 / $16.00 / $18.80	Professional	26	$12.64	$16.00	$18.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $22.12 / $28.00 / $32.90	Professional	TC	$22.12	$28.00	$32.90