Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.23 / $67.58 / $136.59	Facility	26	$22.23	$67.58	$136.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.94 / $70.65 / $273.12	Professional		$35.94	$70.65	$273.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.48 / $35.57 / $136.18	Professional	26	$23.48	$35.57	$136.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.09 / $47.17 / $136.94	Professional	TC	$13.09	$47.17	$136.94
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.86 / $87.41 / $89.95	Facility	26	$84.86	$87.41	$89.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.73 / $95.41 / $119.26	Professional		$77.73	$95.41	$119.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.81 / $55.85 / $69.81	Professional	26	$47.81	$55.85	$69.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.28 / $39.56 / $49.45	Professional	TC	$33.28	$39.56	$49.45
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $36.72 / $67.23 / $195.18	Professional		$36.72	$67.23	$195.18
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.24 / $36.64 / $105.80	Professional	26	$22.24	$36.64	$105.80
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $14.48 / $26.99 / $90.74	Professional	TC	$14.48	$26.99	$90.74
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $87.41 / $87.41 / $87.41	Facility	26	$87.41	$87.41	$87.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $49.73 / $88.21 / $311.00	Professional		$49.73	$88.21	$311.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $25.77 / $34.01 / $338.48	Professional	26	$25.77	$34.01	$338.48
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.57 / $41.36 / $338.48	Professional	TC	$23.57	$41.36	$338.48
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $87.41 / $89.95 / $132.84	Facility	26	$87.41	$89.95	$132.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $77.73 / $118.39 / $159.16	Professional		$77.73	$118.39	$159.16
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $17.20 / $33.22 / $68.83	Professional		$17.20	$33.22	$68.83
United Facility/Professional Professional Modifier Low / Median / High Price $49.34 / $67.28 / $305.72	Professional		$49.34	$67.28	$305.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.77 / $30.50 / $46.33	Professional	26	$25.77	$30.50	$46.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.57 / $32.15 / $60.52	Professional	TC	$23.57	$32.15	$60.52
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $59.88 / $75.80 / $89.20	Professional		$59.88	$75.80	$89.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $35.08 / $44.40 / $52.20	Professional	26	$35.08	$44.40	$52.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $24.81 / $31.40 / $37.00	Professional	TC	$24.81	$31.40	$37.00