Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.18 / $46.28 / $85.74	Facility	26	$19.18	$46.28	$85.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.25 / $51.24 / $102.91	Professional		$44.25	$51.24	$102.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.57 / $13.97 / $26.51	Professional	26	$12.57	$13.97	$26.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.27 / $37.71 / $66.90	Professional	TC	$31.27	$37.71	$66.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.80 / $50.26 / $51.73	Facility	26	$48.80	$50.26	$51.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.55 / $126.44 / $158.05	Professional		$51.55	$126.44	$158.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.07 / $31.80 / $39.75	Professional	26	$14.07	$31.80	$39.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.11 / $94.64 / $118.29	Professional	TC	$38.11	$94.64	$118.29
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $53.06 / $73.65 / $269.19	Professional		$53.06	$73.65	$269.19
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.41 / $20.10 / $78.43	Professional	26	$14.41	$20.10	$78.43
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.65 / $52.46 / $138.84	Professional	TC	$38.65	$52.46	$138.84
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $50.26 / $70.00 / $70.00	Facility	26	$50.26	$70.00	$70.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $48.22 / $75.78 / $241.66	Professional		$48.22	$75.78	$241.66
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $12.75 / $18.98 / $91.83	Professional	26	$12.75	$18.98	$91.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $30.93 / $45.81 / $233.75	Professional	TC	$30.93	$45.81	$233.75
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $50.26 / $51.73 / $79.38	Facility	26	$50.26	$51.73	$79.38
Midlands Facility/Professional Professional Modifier Low / Median / High Price $99.42 / $115.28 / $183.40	Professional		$99.42	$115.28	$183.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.39 / $48.24 / $89.16	Professional		$14.39	$48.24	$89.16
United Facility/Professional Professional Modifier Low / Median / High Price $49.76 / $59.71 / $156.59	Professional		$49.76	$59.71	$156.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.40 / $17.50 / $38.04	Professional	26	$14.40	$17.50	$38.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.18 / $45.76 / $108.32	Professional	TC	$35.18	$45.76	$108.32
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $78.84 / $99.80 / $117.50	Professional		$78.84	$99.80	$117.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $20.46 / $25.90 / $30.50	Professional	26	$20.46	$25.90	$30.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $58.46 / $74.00 / $87.00	Professional	TC	$58.46	$74.00	$87.00