Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.16 / $63.57 / $148.96	Professional		$53.16	$63.57	$148.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.86 / $21.75 / $39.49	Professional	26	$18.86	$21.75	$39.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.02 / $41.81 / $109.46	Professional	TC	$31.02	$41.81	$109.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.64 / $103.98 / $175.74	Professional		$42.64	$103.98	$175.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.35 / $45.00 / $65.39	Professional	26	$20.35	$45.00	$65.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.30 / $66.81 / $102.53	Professional	TC	$22.30	$66.81	$102.53
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $38.07 / $86.29 / $130.90	Professional		$38.07	$86.29	$130.90
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.15 / $40.97 / $61.92	Professional	26	$21.15	$40.97	$61.92
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $7.81 / $45.27 / $89.93	Professional	TC	$7.81	$45.27	$89.93
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $113.54 / $113.54 / $113.54	Facility	26	$113.54	$113.54	$113.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $67.12 / $109.27 / $453.03	Professional		$67.12	$109.27	$453.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $24.62 / $40.61 / $158.49	Professional	26	$24.62	$40.61	$158.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $41.07 / $66.86 / $300.38	Professional	TC	$41.07	$66.86	$300.38
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $65.73 / $65.73 / $65.73	Facility	26	$65.73	$65.73	$65.73
Midlands Facility/Professional Professional Modifier Low / Median / High Price $84.00 / $121.69 / $164.57	Professional		$84.00	$121.69	$164.57
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $24.93 / $76.40 / $139.08	Professional		$24.93	$76.40	$139.08
United Facility/Professional Professional Modifier Low / Median / High Price $67.12 / $69.13 / $157.13	Professional		$67.12	$69.13	$157.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.02 / $26.31 / $60.99	Professional	26	$26.02	$26.31	$60.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.07 / $42.30 / $98.84	Professional	TC	$41.07	$42.30	$98.84
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $141.80 / $166.90 / $196.30	Professional		$141.80	$166.90	$196.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $42.60 / $50.10 / $58.90	Professional	26	$42.60	$50.10	$58.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $99.30 / $116.80 / $137.40	Professional	TC	$99.30	$116.80	$137.40