Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $55.01 / $145.28	Professional		$32.34	$55.01	$145.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.05 / $30.73 / $41.06	Professional	26	$18.05	$30.73	$41.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.27 / $24.28 / $97.42	Professional	TC	$14.27	$24.28	$97.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.20 / $101.20 / $316.45	Professional		$48.20	$101.20	$316.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.86 / $52.82 / $92.55	Professional	26	$26.86	$52.82	$92.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.02 / $44.28 / $222.78	Professional	TC	$22.02	$44.28	$222.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $34.52 / $53.49 / $231.87	Professional		$34.52	$53.49	$231.87
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.47 / $29.93 / $127.59	Professional	26	$19.47	$29.93	$127.59
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $15.05 / $23.22 / $160.25	Professional	TC	$15.05	$23.22	$160.25
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $201.45 / $201.45 / $201.45	Facility	26	$201.45	$201.45	$201.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.72 / $98.70 / $764.92	Professional		$43.72	$98.70	$764.92
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $23.97 / $49.00 / $382.94	Professional	26	$23.97	$49.00	$382.94
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $17.48 / $40.45 / $585.86	Professional	TC	$17.48	$40.45	$585.86
Midlands Facility/Professional Professional Modifier Low / Median / High Price $60.34 / $89.15 / $227.50	Professional		$60.34	$89.15	$227.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $18.13 / $35.65 / $69.43	Professional		$18.13	$35.65	$69.43
United Facility/Professional Professional Modifier Low / Median / High Price $40.70 / $74.00 / $149.72	Professional		$40.70	$74.00	$149.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.74 / $37.11 / $59.11	Professional	26	$22.74	$37.11	$59.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.96 / $27.79 / $101.87	Professional	TC	$16.96	$27.79	$101.87
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $56.49 / $71.50 / $84.10	Professional		$56.49	$71.50	$84.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $30.65 / $38.79 / $45.70	Professional	26	$30.65	$38.79	$45.70
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $25.83 / $32.70 / $38.40	Professional	TC	$25.83	$32.70	$38.40