Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $14.61 / $81.58 / $268.13	Facility		$14.61	$81.58	$268.13
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.99 / $29.70 / $54.92	Facility	26	$14.99	$29.70	$54.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.85 / $13.26 / $39.11	Professional		$9.85	$13.26	$39.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.82 / $7.85 / $43.00	Professional	26	$6.82	$7.85	$43.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $11.36 / $11.36 / $11.36	Professional	50	$11.36	$11.36	$11.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $3.01 / $3.79 / $5.46	Professional	TC	$3.01	$3.79	$5.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.96 / $46.31 / $47.66	Facility		$44.96	$46.31	$47.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.45 / $30.33 / $31.22	Facility	26	$29.45	$30.33	$31.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.58 / $24.82 / $37.02	Professional		$13.58	$24.82	$37.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.84 / $17.07 / $24.21	Professional	26	$9.84	$17.07	$24.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.62 / $7.76 / $10.79	Professional	TC	$3.62	$7.76	$10.79
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $17.73 / $30.99	Professional		$10.23	$17.73	$30.99
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.09 / $12.74 / $25.52	Professional	26	$7.09	$12.74	$25.52
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $3.13 / $5.15 / $12.67	Professional	TC	$3.13	$5.15	$12.67
Medica Facility/Professional Facility Modifier Low / Median / High Price $10.50 / $25.27 / $65.38	Facility		$10.50	$25.27	$65.38
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $30.33 / $100.00 / $100.00	Facility	26	$30.33	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $11.90 / $20.99 / $1,428.44	Professional		$11.90	$20.99	$1,428.44
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.30 / $10.28 / $1,274.28	Professional	26	$8.30	$10.28	$1,274.28
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $3.26 / $4.76 / $988.10	Professional	TC	$3.26	$4.76	$988.10
Midlands Facility/Professional Facility Modifier Low / Median / High Price $20.99 / $26.09 / $46.31	Facility		$20.99	$26.09	$46.31
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $30.33 / $31.22 / $42.54	Facility	26	$30.33	$31.22	$42.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $20.99 / $26.25 / $33.94	Professional		$20.99	$26.25	$33.94
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.80 / $14.80 / $39.50	Professional		$14.80	$14.80	$39.50
United Facility/Professional Facility Modifier Low / Median / High Price $31.56 / $51.64 / $66.75	Facility		$31.56	$51.64	$66.75
United Facility/Professional Professional Modifier Low / Median / High Price $11.25 / $14.65 / $26.16	Professional		$11.25	$14.65	$26.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.21 / $9.96 / $17.97	Professional	26	$8.21	$9.96	$17.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.28 / $4.38 / $8.64	Professional	TC	$3.28	$4.38	$8.64
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $15.96 / $20.20 / $23.70	Professional		$15.96	$20.20	$23.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $10.74 / $13.60 / $16.00	Professional	26	$10.74	$13.60	$16.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $5.14 / $6.50 / $7.70	Professional	TC	$5.14	$6.50	$7.70