Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.67 / $16.60 / $53.54	Facility	26	$8.67	$16.60	$53.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.76 / $29.48 / $144.00	Professional		$25.76	$29.48	$144.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.47 / $9.27 / $20.86	Professional	26	$8.47	$9.27	$20.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.28 / $19.89 / $35.13	Professional	TC	$17.28	$19.89	$35.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.75 / $33.72 / $34.72	Facility	26	$32.75	$33.72	$34.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.40 / $74.47 / $102.48	Professional		$32.40	$74.47	$102.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.97 / $21.44 / $29.13	Professional	26	$9.97	$21.44	$29.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.43 / $53.52 / $66.90	Professional	TC	$22.43	$53.52	$66.90
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $28.05 / $41.83 / $150.00	Professional		$28.05	$41.83	$150.00
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.75 / $12.59 / $36.97	Professional	26	$8.75	$12.59	$36.97
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.30 / $28.70 / $91.26	Professional	TC	$19.30	$28.70	$91.26
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $33.72 / $80.00 / $80.00	Facility	26	$33.72	$80.00	$80.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.12 / $53.72 / $197.88	Professional		$28.12	$53.72	$197.88
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.80 / $13.01 / $232.03	Professional	26	$8.80	$13.01	$232.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $17.98 / $26.20 / $142.29	Professional	TC	$17.98	$26.20	$142.29
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $33.72 / $34.72 / $52.50	Facility	26	$33.72	$34.72	$52.50
Midlands Facility/Professional Professional Modifier Low / Median / High Price $53.72 / $65.56 / $108.68	Professional		$53.72	$65.56	$108.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.48 / $29.99 / $52.84	Professional		$9.48	$29.99	$52.84
United Facility/Professional Professional Modifier Low / Median / High Price $29.18 / $36.13 / $82.36	Professional		$29.18	$36.13	$82.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.65 / $13.01 / $31.44	Professional	26	$9.65	$13.01	$31.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.95 / $26.20 / $63.42	Professional	TC	$18.95	$26.20	$63.42
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $59.20 / $69.59	Professional		$46.77	$59.20	$69.59
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 $33.10 / $41.90 / $49.30	Professional	TC	$33.10	$41.90	$49.30