Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.56 / $40.56 / $124.12	Facility	26	$40.56	$40.56	$124.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.54 / $45.72 / $251.00	Professional		$39.54	$45.72	$251.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.35 / $24.32 / $130.00	Professional	26	$21.35	$24.32	$130.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.21 / $21.75 / $47.53	Professional	TC	$18.21	$21.75	$47.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $76.34 / $78.58	Facility	26	$74.13	$76.34	$78.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.36 / $102.39 / $129.66	Professional		$62.36	$102.39	$129.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.49 / $53.52 / $74.44	Professional	26	$28.49	$53.52	$74.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.02 / $49.54 / $72.61	Professional	TC	$29.02	$49.54	$72.61
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $39.46 / $72.56 / $240.46	Professional		$39.46	$72.56	$240.46
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.86 / $38.20 / $136.40	Professional	26	$21.86	$38.20	$136.40
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.60 / $31.26 / $136.40	Professional	TC	$17.60	$31.26	$136.40
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $76.34 / $105.96 / $105.96	Facility	26	$76.34	$105.96	$105.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $47.64 / $80.79 / $495.56	Professional		$47.64	$80.79	$495.56
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $24.58 / $32.00 / $151.44	Professional	26	$24.58	$32.00	$151.44
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.37 / $30.28 / $367.63	Professional	TC	$21.37	$30.28	$367.63
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $76.34 / $78.58 / $133.08	Facility	26	$76.34	$78.58	$133.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $80.41 / $96.75 / $129.66	Professional		$80.41	$96.75	$129.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $19.72 / $39.02 / $77.18	Professional		$19.72	$39.02	$77.18
United Facility/Professional Professional Modifier Low / Median / High Price $45.30 / $57.77 / $101.94	Professional		$45.30	$57.77	$101.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.57 / $30.75 / $56.54	Professional	26	$24.57	$30.75	$56.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.92 / $25.77 / $52.85	Professional	TC	$20.92	$25.77	$52.85
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $61.86 / $78.30 / $92.10	Professional		$61.86	$78.30	$92.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $32.79 / $41.50 / $48.80	Professional	26	$32.79	$41.50	$48.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $29.07 / $36.79 / $43.20	Professional	TC	$29.07	$36.79	$43.20