Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.46 / $55.99 / $74.72	Facility	26	$29.46	$55.99	$74.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.64 / $57.44 / $224.00	Professional		$28.64	$57.44	$224.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.21 / $31.74 / $129.00	Professional	26	$18.21	$31.74	$129.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $7.88 / $11.47 / $86.32	Professional	TC	$7.88	$11.47	$86.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.72 / $74.90 / $77.08	Facility	26	$72.72	$74.90	$77.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.61 / $137.35 / $186.17	Professional		$37.61	$137.35	$186.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.51 / $74.47 / $93.08	Professional	26	$23.51	$74.47	$93.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.93 / $64.23 / $93.08	Professional	TC	$12.93	$64.23	$93.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $57.55 / $86.51 / $138.41	Professional		$57.55	$86.51	$138.41
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.59 / $45.45 / $120.65	Professional	26	$30.59	$45.45	$120.65
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.96 / $40.88 / $120.65	Professional	TC	$26.96	$40.88	$120.65
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $77.38 / $148.36 / $148.36	Facility	26	$77.38	$148.36	$148.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.15 / $70.08 / $189.52	Professional		$35.15	$70.08	$189.52
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $22.20 / $30.93 / $197.46	Professional	26	$22.20	$30.93	$197.46
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $10.25 / $35.92 / $214.27	Professional	TC	$10.25	$35.92	$214.27
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $74.90 / $77.08 / $181.20	Facility	26	$74.90	$77.08	$181.20
Midlands Facility/Professional Professional Modifier Low / Median / High Price $61.59 / $124.89 / $142.46	Professional		$61.59	$124.89	$142.46
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.29 / $57.21 / $108.06	Professional		$30.29	$57.21	$108.06
United Facility/Professional Professional Modifier Low / Median / High Price $35.15 / $61.89 / $106.23	Professional		$35.15	$61.89	$106.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.69 / $29.88 / $68.09	Professional	26	$22.69	$29.88	$68.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.18 / $33.20 / $59.88	Professional	TC	$10.18	$33.20	$59.88
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $90.38 / $114.40 / $134.60	Professional		$90.38	$114.40	$134.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $45.90 / $58.10 / $68.40	Professional	26	$45.90	$58.10	$68.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $44.48 / $56.30 / $66.30	Professional	TC	$44.48	$56.30	$66.30