Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.47 / $43.75 / $65.65	Professional		$35.47	$43.75	$65.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $19.82 / $29.81	Professional	26	$15.85	$19.82	$29.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.62 / $24.37 / $35.84	Professional	TC	$19.62	$24.37	$35.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.82 / $89.55 / $139.94	Professional		$36.82	$89.55	$139.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.66 / $40.00 / $58.38	Professional	26	$16.66	$40.00	$58.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.39 / $50.81 / $82.01	Professional	TC	$19.39	$50.81	$82.01
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $33.97 / $52.68 / $145.88	Professional		$33.97	$52.68	$145.88
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.25 / $24.59 / $61.98	Professional	26	$15.25	$24.59	$61.98
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.54 / $25.92 / $77.09	Professional	TC	$18.54	$25.92	$77.09
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $47.60 / $47.60 / $100.00	Facility	26	$47.60	$47.60	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.62 / $74.63 / $188.96	Professional		$42.62	$74.63	$188.96
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $20.09 / $26.41 / $57.50	Professional	26	$20.09	$26.41	$57.50
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.53 / $31.62 / $87.51	Professional	TC	$22.53	$31.62	$87.51
Midlands Facility/Professional Professional Modifier Low / Median / High Price $71.58 / $106.00 / $125.67	Professional		$71.58	$106.00	$125.67
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $20.91 / $42.18 / $83.21	Professional		$20.91	$42.18	$83.21
United Facility/Professional Professional Modifier Low / Median / High Price $42.62 / $53.83 / $102.73	Professional		$42.62	$53.83	$102.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.70 / $24.90 / $48.41	Professional	26	$19.70	$24.90	$48.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.53 / $28.46 / $54.33	Professional	TC	$22.53	$28.46	$54.33
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $63.20 / $86.30 / $89.70	Professional		$63.20	$86.30	$89.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $27.50 / $37.60 / $39.10	Professional	26	$27.50	$37.60	$39.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $35.70 / $48.70 / $50.60	Professional	TC	$35.70	$48.70	$50.60