Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.76 / $42.52 / $91.09	Facility	26	$25.76	$42.52	$91.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.42 / $57.49 / $228.00	Professional		$46.42	$57.49	$228.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.07 / $34.84 / $95.04	Professional	26	$26.07	$34.84	$95.04
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $26.81 / $60.30 / $233.00	Professional	52	$26.81	$60.30	$233.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.65 / $25.33 / $75.51	Professional	TC	$20.65	$25.33	$75.51
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.42 / $99.31 / $102.21	Facility	26	$96.42	$99.31	$102.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.90 / $121.78 / $152.22	Professional		$50.90	$121.78	$152.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.60 / $65.16 / $81.45	Professional	26	$28.60	$65.16	$81.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.84 / $56.63 / $70.78	Professional	TC	$23.84	$56.63	$70.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $52.37 / $71.02 / $150.71	Professional		$52.37	$71.02	$150.71
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.99 / $38.34 / $70.02	Professional	26	$28.99	$38.34	$70.02
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.39 / $31.13 / $85.46	Professional	TC	$23.39	$31.13	$85.46
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $99.31 / $128.65 / $128.65	Facility	26	$99.31	$128.65	$128.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $57.45 / $95.10 / $238.84	Professional		$57.45	$95.10	$238.84
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $30.68 / $42.40 / $182.49	Professional	26	$30.68	$42.40	$182.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $30.31 / $151.88	Professional	TC	$23.99	$30.31	$151.88
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $99.31 / $102.21 / $157.50	Facility	26	$99.31	$102.21	$157.50
Midlands Facility/Professional Professional Modifier Low / Median / High Price $98.61 / $111.72 / $177.73	Professional		$98.61	$111.72	$177.73
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $23.50 / $47.03 / $87.50	Professional		$23.50	$47.03	$87.50
United Facility/Professional Professional Modifier Low / Median / High Price $52.23 / $68.01 / $112.82	Professional		$52.23	$68.01	$112.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.31 / $38.17 / $87.46	Professional	26	$29.31	$38.17	$87.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.92 / $29.84 / $48.50	Professional	TC	$22.92	$29.84	$48.50
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $76.47 / $96.80 / $113.80	Professional		$76.47	$96.80	$113.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $41.40 / $52.40 / $61.60	Professional	26	$41.40	$52.40	$61.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $35.08 / $44.40 / $52.20	Professional	TC	$35.08	$44.40	$52.20