Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.25 / $47.90 / $94.11	Professional		$41.25	$47.90	$94.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.47 / $31.62 / $57.55	Professional	26	$27.47	$31.62	$57.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.77 / $16.28 / $36.54	Professional	TC	$13.77	$16.28	$36.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.34 / $98.56 / $142.91	Professional		$34.34	$98.56	$142.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.85 / $64.31 / $95.95	Professional	26	$23.85	$64.31	$95.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.49 / $33.77 / $49.24	Professional	TC	$10.49	$33.77	$49.24
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $72.09 / $87.12 / $109.29	Professional		$72.09	$87.12	$109.29
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.13 / $56.45 / $67.93	Professional	26	$48.13	$56.45	$67.93
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.35 / $25.95 / $41.38	Professional	TC	$20.35	$25.95	$41.38
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $165.02 / $165.02 / $165.02	Facility	26	$165.02	$165.02	$165.02
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.65 / $97.24 / $353.10	Professional		$54.65	$97.24	$353.10
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $37.10 / $39.70 / $231.59	Professional	26	$37.10	$39.70	$231.59
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $16.37 / $21.95 / $121.51	Professional	TC	$16.37	$21.95	$121.51
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $98.90 / $98.90 / $98.90	Facility	26	$98.90	$98.90	$98.90
Midlands Facility/Professional Professional Modifier Low / Median / High Price $65.61 / $98.56 / $139.36	Professional		$65.61	$98.56	$139.36
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $19.21 / $51.74 / $94.69	Professional		$19.21	$51.74	$94.69
United Facility/Professional Professional Modifier Low / Median / High Price $54.65 / $56.29 / $131.96	Professional		$54.65	$56.29	$131.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.26 / $39.43 / $108.52	Professional	26	$38.26	$39.43	$108.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.37 / $17.89 / $39.70	Professional	TC	$16.37	$17.89	$39.70
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $94.80 / $111.50 / $131.10	Professional		$94.80	$111.50	$131.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $61.80 / $72.80 / $85.60	Professional	26	$61.80	$72.80	$85.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $32.90 / $38.70 / $45.50	Professional	TC	$32.90	$38.70	$45.50