Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.94 / $22.09 / $70.43	Facility	26	$11.94	$22.09	$70.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.85 / $42.49 / $194.00	Professional		$34.85	$42.49	$194.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.63 / $13.21 / $31.28	Professional	26	$11.63	$13.21	$31.28
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $18.12 / $19.75 / $28.71	Professional	52	$18.12	$19.75	$28.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.09 / $27.74 / $52.02	Professional	TC	$23.09	$27.74	$52.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.97 / $46.32 / $47.67	Facility	26	$44.97	$46.32	$47.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.86 / $105.50 / $131.87	Professional		$45.86	$105.50	$131.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.93 / $29.48 / $37.02	Professional	26	$13.93	$29.48	$37.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.23 / $72.34 / $95.02	Professional	TC	$31.23	$72.34	$95.02
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $39.65 / $59.58 / $150.00	Professional		$39.65	$59.58	$150.00
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.12 / $18.10 / $42.06	Professional	26	$12.12	$18.10	$42.06
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.53 / $41.75 / $81.11	Professional	TC	$27.53	$41.75	$81.11
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $46.32 / $80.00 / $80.00	Facility	26	$46.32	$80.00	$80.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.90 / $63.23 / $290.45	Professional		$40.90	$63.23	$290.45
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.37 / $17.30 / $82.68	Professional	26	$13.37	$17.30	$82.68
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.26 / $36.00 / $207.72	Professional	TC	$26.26	$36.00	$207.72
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $46.32 / $47.67 / $72.12	Facility	26	$46.32	$47.67	$72.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $63.23 / $85.90 / $146.26	Professional		$63.23	$85.90	$146.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.38 / $40.45 / $78.13	Professional		$13.38	$40.45	$78.13
United Facility/Professional Professional Modifier Low / Median / High Price $40.94 / $53.31 / $82.37	Professional		$40.94	$53.31	$82.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.37 / $16.88 / $29.65	Professional	26	$13.37	$16.88	$29.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.71 / $36.00 / $72.52	Professional	TC	$26.71	$36.00	$72.52
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $66.20 / $83.80 / $98.60	Professional		$66.20	$83.80	$98.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $18.96 / $24.00 / $28.30	Professional	26	$18.96	$24.00	$28.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $47.24 / $59.80 / $70.30	Professional	TC	$47.24	$59.80	$70.30