Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $8.91 / $79.43 / $199.53	Facility		$8.91	$79.43	$199.53
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $6.03 / $50.12	Facility	26	$6.03	$6.03	$50.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $15.14 / $48.98	Professional		$9.33	$15.14	$48.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $8.91 / $45.71	Professional	26	$6.03	$8.91	$45.71
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $11.48 / $29.51 / $29.51	Professional	50	$11.48	$29.51	$29.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $2.00 / $3.39 / $12.59	Professional	TC	$2.00	$3.39	$12.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $46.77 / $47.86	Facility		$44.67	$46.77	$47.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.51 / $30.20 / $30.90	Facility	26	$29.51	$30.20	$30.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $25.12 / $31.62	Professional		$14.13	$25.12	$31.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $17.38 / $21.88	Professional	26	$9.55	$17.38	$21.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $4.37 / $7.94 / $10.00	Professional	TC	$4.37	$7.94	$10.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $23.99 / $36.31	Professional		$10.47	$23.99	$36.31
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $18.20 / $29.51	Professional	26	$7.24	$18.20	$29.51
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $3.16 / $5.75 / $29.51	Professional	TC	$3.16	$5.75	$29.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $10.72 / $26.30 / $81.28	Facility		$10.72	$26.30	$81.28
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $100.00 / $100.00	Facility	26	$30.20	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $21.38 / $1,412.54	Professional		$11.75	$21.38	$1,412.54
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $10.47 / $1,288.25	Professional	26	$8.13	$10.47	$1,288.25
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $3.09 / $4.79 / $977.24	Professional	TC	$3.09	$4.79	$977.24
Midlands Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $26.30 / $30.20	Professional		$21.88	$26.30	$30.20
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $18.20 / $23.99	Professional	26	$15.49	$18.20	$23.99
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $5.37 / $7.76 / $9.55	Professional	TC	$5.37	$7.76	$9.55
Midlands Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $47.86 / $47.86	Facility		$47.86	$47.86	$47.86
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	26	$30.90	$30.90	$30.90
Midlands Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $30.20 / $30.90	Professional		$25.70	$30.20	$30.90
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $18.62 / $20.89	Professional	26	$17.78	$18.62	$20.89
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $6.76 / $9.55 / $11.48	Professional	TC	$6.76	$9.55	$11.48
United Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $66.07 / $89.13	Facility		$38.02	$66.07	$89.13
United Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $13.80 / $26.92	Professional		$11.22	$13.80	$26.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $9.77 / $18.62	Professional	26	$8.13	$9.77	$18.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.16 / $4.37 / $8.71	Professional	TC	$3.16	$4.37	$8.71
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $20.42 / $23.44	Professional		$20.42	$20.42	$23.44
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $13.49 / $15.85	Professional	26	$13.49	$13.49	$15.85
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $6.46 / $6.46 / $7.76	Professional	TC	$6.46	$6.46	$7.76