Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.60 / $39.35 / $158.00	Professional		$28.60	$39.35	$158.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.06 / $14.56 / $56.32	Professional	26	$10.06	$14.56	$56.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.77 / $23.06 / $37.39	Professional	TC	$18.77	$23.06	$37.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.13 / $73.38 / $129.49	Professional		$29.13	$73.38	$129.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.39 / $26.17 / $43.16	Professional	26	$11.39	$26.17	$43.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.73 / $48.21 / $75.28	Professional	TC	$18.73	$48.21	$75.28
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $29.89 / $41.63 / $250.80	Professional		$29.89	$41.63	$250.80
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.56 / $14.84 / $103.91	Professional	26	$10.56	$14.84	$103.91
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.32 / $26.23 / $138.46	Professional	TC	$19.32	$26.23	$138.46
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $70.00 / $70.00 / $70.00	Facility	26	$70.00	$70.00	$70.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.17 / $74.09 / $195.66	Professional		$40.17	$74.09	$195.66
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.90 / $29.18 / $69.84	Professional	26	$15.90	$29.18	$69.84
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.27 / $45.85 / $129.61	Professional	TC	$24.27	$45.85	$129.61
Midlands Facility/Professional Professional Modifier Low / Median / High Price $48.75 / $73.38 / $80.69	Professional		$48.75	$73.38	$80.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $40.40 / $40.40 / $40.40	Professional		$40.40	$40.40	$40.40
United Facility/Professional Professional Modifier Low / Median / High Price $38.42 / $55.89 / $95.01	Professional		$38.42	$55.89	$95.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.21 / $23.99 / $37.61	Professional	26	$15.21	$23.99	$37.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.45 / $46.42 / $57.39	Professional	TC	$23.45	$46.42	$57.39
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $45.35 / $57.40 / $67.50	Professional		$45.35	$57.40	$67.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $15.41 / $19.50 / $23.00	Professional	26	$15.41	$19.50	$23.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $29.86 / $37.79 / $44.50	Professional	TC	$29.86	$37.79	$44.50