Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.18 / $59.76 / $89.64	Professional		$48.18	$59.76	$89.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.05 / $35.22 / $52.87	Professional	26	$28.05	$35.22	$52.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.13 / $24.53 / $36.77	Professional	TC	$20.13	$24.53	$36.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.38 / $108.75 / $166.94	Professional		$49.38	$108.75	$166.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.21 / $69.23 / $96.08	Professional	26	$29.21	$69.23	$96.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.55 / $47.01 / $65.50	Professional	TC	$19.55	$47.01	$65.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $46.74 / $72.23 / $151.72	Professional		$46.74	$72.23	$151.72
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.29 / $42.24 / $94.17	Professional	26	$27.29	$42.24	$94.17
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.26 / $26.17 / $73.73	Professional	TC	$19.26	$26.17	$73.73
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $84.68 / $84.68 / $165.02	Facility	26	$84.68	$84.68	$165.02
Medica Facility/Professional Professional Modifier Low / Median / High Price $57.53 / $76.26 / $166.94	Professional		$57.53	$76.26	$166.94
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $35.31 / $44.60 / $101.10	Professional	26	$35.31	$44.60	$101.10
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.08 / $28.07 / $60.61	Professional	TC	$22.08	$28.07	$60.61
Midlands Facility/Professional Professional Modifier Low / Median / High Price $83.00 / $129.51 / $166.94	Professional		$83.00	$129.51	$166.94
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $27.96 / $59.11 / $113.33	Professional		$27.96	$59.11	$113.33
United Facility/Professional Professional Modifier Low / Median / High Price $57.53 / $69.72 / $139.88	Professional		$57.53	$69.72	$139.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.17 / $42.87 / $85.12	Professional	26	$33.17	$42.87	$85.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.08 / $26.89 / $53.56	Professional	TC	$22.08	$26.89	$53.56
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $86.20 / $117.70 / $122.40	Professional		$86.20	$117.70	$122.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $49.20 / $67.20 / $69.90	Professional	26	$49.20	$67.20	$69.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $37.00 / $50.50 / $52.60	Professional	TC	$37.00	$50.50	$52.60