Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.80 / $58.08 / $64.75	Professional		$49.80	$58.08	$64.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.70 / $21.31 / $23.76	Professional	26	$18.70	$21.31	$23.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.11 / $36.77 / $40.99	Professional	TC	$31.11	$36.77	$40.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.18 / $114.70 / $176.85	Professional		$47.18	$114.70	$176.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.05 / $42.50 / $68.18	Professional	26	$16.05	$42.50	$68.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.11 / $74.34 / $112.89	Professional	TC	$31.11	$74.34	$112.89
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $50.93 / $104.41 / $358.70	Professional		$50.93	$104.41	$358.70
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.71 / $40.58 / $232.23	Professional	26	$19.71	$40.58	$232.23
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.22 / $63.82 / $126.47	Professional	TC	$31.22	$63.82	$126.47
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $110.49 / $110.49 / $110.49	Facility	26	$110.49	$110.49	$110.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $57.80 / $114.70 / $438.19	Professional		$57.80	$114.70	$438.19
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $21.53 / $27.79 / $158.25	Professional	26	$21.53	$27.79	$158.25
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $36.27 / $47.28 / $279.94	Professional	TC	$36.27	$47.28	$279.94
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $70.97 / $70.97 / $70.97	Facility	26	$70.97	$70.97	$70.97
Midlands Facility/Professional Professional Modifier Low / Median / High Price $76.78 / $120.59 / $175.35	Professional		$76.78	$120.59	$175.35
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $23.97 / $59.92 / $110.19	Professional		$23.97	$59.92	$110.19
United Facility/Professional Professional Modifier Low / Median / High Price $69.86 / $74.58 / $169.44	Professional		$69.86	$74.58	$169.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.94 / $27.79 / $59.45	Professional	26	$26.94	$27.79	$59.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $42.88 / $44.17 / $100.38	Professional	TC	$42.88	$44.17	$100.38
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $111.80 / $131.50 / $154.60	Professional		$111.80	$131.50	$154.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $41.40 / $48.70 / $57.30	Professional	26	$41.40	$48.70	$57.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $70.40 / $82.80 / $97.30	Professional	TC	$70.40	$82.80	$97.30