Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.44 / $14.64 / $31.04	Facility	26	$8.44	$14.64	$31.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.97 / $51.20 / $228.23	Professional		$32.97	$51.20	$228.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.44 / $9.46 / $30.00	Professional	26	$8.44	$9.46	$30.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.51 / $34.03 / $94.21	Professional	TC	$24.51	$34.03	$94.21
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $172.43 / $177.60 / $182.78	Facility	26	$172.43	$177.60	$182.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.19 / $94.13 / $142.38	Professional		$58.19	$94.13	$142.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.97 / $20.94 / $29.13	Professional	26	$9.97	$20.94	$29.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.25 / $72.06 / $118.18	Professional	TC	$44.25	$72.06	$118.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $34.29 / $51.34 / $240.35	Professional		$34.29	$51.34	$240.35
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.75 / $12.59 / $39.13	Professional	26	$8.75	$12.59	$39.13
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.54 / $38.72 / $209.59	Professional	TC	$25.54	$38.72	$209.59
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $80.00 / $80.00 / $80.00	Facility	26	$80.00	$80.00	$80.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.33 / $72.66 / $539.95	Professional		$40.33	$72.66	$539.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.00 / $12.58 / $97.55	Professional	26	$9.00	$12.58	$97.55
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.70 / $42.31 / $492.53	Professional	TC	$29.70	$42.31	$492.53
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $52.50 / $182.78 / $182.78	Facility	26	$52.50	$182.78	$182.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $72.66 / $86.54 / $190.00	Professional		$72.66	$86.54	$190.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.48 / $37.00 / $64.76	Professional		$9.48	$37.00	$64.76
United Facility/Professional Professional Modifier Low / Median / High Price $40.33 / $47.74 / $115.37	Professional		$40.33	$47.74	$115.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.61 / $12.13 / $29.05	Professional	26	$9.61	$12.13	$29.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.70 / $35.15 / $84.97	Professional	TC	$29.70	$35.15	$84.97
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $57.43 / $72.70 / $85.50	Professional		$57.43	$72.70	$85.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $13.67 / $17.30 / $20.30	Professional	26	$13.67	$17.30	$20.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $43.85 / $55.50 / $65.30	Professional	TC	$43.85	$55.50	$65.30