Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.18 / $64.97 / $72.44	Professional		$55.18	$64.97	$72.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $21.47 / $23.94	Professional	26	$18.62	$21.47	$23.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.56 / $43.50 / $48.50	Professional	TC	$36.56	$43.50	$48.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.24 / $105.32 / $189.88	Professional		$41.24	$105.32	$189.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.35 / $46.00 / $76.58	Professional	26	$20.35	$46.00	$76.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $67.95 / $103.64	Professional	TC	$20.89	$67.95	$103.64
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $91.37 / $132.97	Professional		$40.74	$91.37	$132.97
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.86 / $40.44 / $61.92	Professional	26	$24.86	$40.44	$61.92
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $9.15 / $50.52 / $91.47	Professional	TC	$9.15	$50.52	$91.47
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $112.04 / $112.04 / $112.04	Facility	26	$112.04	$112.04	$112.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $62.38 / $110.85 / $466.08	Professional		$62.38	$110.85	$466.08
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $24.31 / $39.53 / $186.58	Professional	26	$24.31	$39.53	$186.58
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $37.04 / $63.65 / $309.75	Professional	TC	$37.04	$63.65	$309.75
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $64.11 / $64.11 / $64.11	Facility	26	$64.11	$64.11	$64.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $84.71 / $114.65 / $163.82	Professional		$84.71	$114.65	$163.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $24.63 / $77.00 / $140.32	Professional		$24.63	$77.00	$140.32
United Facility/Professional Professional Modifier Low / Median / High Price $64.50 / $66.44 / $156.44	Professional		$64.50	$66.44	$156.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.36 / $26.16 / $59.46	Professional	26	$25.36	$26.16	$59.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.10 / $40.27 / $86.64	Professional	TC	$39.10	$40.27	$86.64
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $143.00 / $168.20 / $197.80	Professional		$143.00	$168.20	$197.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $42.00 / $49.40 / $58.10	Professional	26	$42.00	$49.40	$58.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $101.00 / $118.80 / $139.69	Professional	TC	$101.00	$118.80	$139.69