Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.05 / $30.05 / $30.05	Facility	26	$30.05	$30.05	$30.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.52 / $25.01 / $49.50	Professional		$21.52	$25.01	$49.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.82 / $18.27 / $33.11	Professional	26	$15.82	$18.27	$33.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $5.70 / $6.74 / $16.38	Professional	TC	$5.70	$6.74	$16.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.73 / $51.82 / $74.45	Professional		$22.73	$51.82	$74.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.20 / $36.68 / $55.38	Professional	26	$17.20	$36.68	$55.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $5.52 / $12.02 / $20.42	Professional	TC	$5.52	$12.02	$20.42
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $47.81 / $50.41	Professional		$25.12	$47.81	$50.41
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.80 / $34.36 / $66.78	Professional	26	$17.80	$34.36	$66.78
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $6.52 / $11.63 / $13.56	Professional	TC	$6.52	$11.63	$13.56
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $95.38 / $95.38 / $95.38	Facility	26	$95.38	$95.38	$95.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.71 / $48.51 / $180.45	Professional		$28.71	$48.51	$180.45
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $22.15 / $23.10 / $134.87	Professional	26	$22.15	$23.10	$134.87
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $6.25 / $7.22 / $45.58	Professional	TC	$6.25	$7.22	$45.58
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $54.76 / $54.76 / $54.76	Facility	26	$54.76	$54.76	$54.76
Midlands Facility/Professional Professional Modifier Low / Median / High Price $34.94 / $51.82 / $73.26	Professional		$34.94	$51.82	$73.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.92 / $27.60 / $50.76	Professional		$8.92	$27.60	$50.76
United Facility/Professional Professional Modifier Low / Median / High Price $28.71 / $29.59 / $67.26	Professional		$28.71	$29.59	$67.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.15 / $22.85 / $51.93	Professional	26	$22.15	$22.85	$51.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $6.55 / $6.74 / $15.33	Professional	TC	$6.55	$6.74	$15.33
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $50.50 / $59.40 / $69.90	Professional		$50.50	$59.40	$69.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $35.70 / $42.10 / $49.50	Professional	26	$35.70	$42.10	$49.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $14.80 / $17.39 / $20.39	Professional	TC	$14.80	$17.39	$20.39