Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $41.69 / $51.29	Facility	26	$20.89	$41.69	$51.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $75.86 / $295.12	Professional		$38.90	$75.86	$295.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $42.66 / $138.04	Professional	26	$19.95	$42.66	$138.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $22.91 / $100.00	Professional	TC	$16.98	$22.91	$100.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $75.86 / $79.43	Facility	26	$74.13	$75.86	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $104.71 / $131.83	Professional		$58.88	$104.71	$131.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $54.95 / $69.18	Professional	26	$28.18	$54.95	$69.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $50.12 / $63.10	Professional	TC	$27.54	$50.12	$63.10
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $114.82 / $323.59	Professional		$40.74	$114.82	$323.59
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $46.77 / $208.93	Professional	26	$22.39	$46.77	$208.93
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $56.23 / $134.90	Professional	TC	$18.62	$56.23	$134.90
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $107.15 / $107.15	Facility	26	$75.86	$107.15	$107.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $85.11 / $501.19	Professional		$45.71	$85.11	$501.19
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $32.36 / $151.36	Professional	26	$24.55	$32.36	$151.36
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $33.88 / $371.54	Professional	TC	$20.89	$33.88	$371.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $104.71 / $128.82	Professional		$89.13	$104.71	$128.82
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $54.95 / $74.13	Professional	26	$47.86	$54.95	$74.13
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $47.86 / $66.07	Professional	TC	$40.74	$47.86	$66.07
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $79.43 / $79.43 / $79.43	Facility	26	$79.43	$79.43	$79.43
Midlands Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $104.71 / $123.03	Professional		$81.28	$104.71	$123.03
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $54.95 / $64.57	Professional	26	$47.86	$54.95	$64.57
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $48.98 / $66.07	Professional	TC	$32.36	$48.98	$66.07
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $41.69 / $77.62	Professional		$20.89	$41.69	$77.62
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $57.54 / $102.33	Professional		$44.67	$57.54	$102.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $29.51 / $56.23	Professional	26	$24.55	$29.51	$56.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $26.30 / $52.48	Professional	TC	$20.89	$26.30	$52.48
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $91.20	Professional		$77.62	$77.62	$91.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $41.69 / $48.98	Professional	26	$41.69	$41.69	$48.98
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $37.15 / $43.65	Professional	TC	$37.15	$37.15	$43.65