Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $25.70 / $51.29	Professional		$19.95	$25.70	$51.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $20.89 / $25.70	Professional	26	$15.85	$20.89	$25.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $3.02 / $3.98 / $6.03	Professional	TC	$3.02	$3.98	$6.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $47.86 / $81.28	Professional		$18.62	$47.86	$81.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $33.88 / $52.48	Professional	26	$15.49	$33.88	$52.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.09 / $6.92 / $48.98	Professional	TC	$3.09	$6.92	$48.98
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $28.84 / $147.91	Professional		$18.20	$28.84	$147.91
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $23.99 / $112.20	Professional	26	$15.49	$23.99	$112.20
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.95 / $4.90 / $41.69	Professional	TC	$2.95	$4.90	$41.69
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $47.86 / $47.86	Facility	26	$47.86	$47.86	$47.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $45.71 / $125.89	Professional		$23.44	$45.71	$125.89
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $28.18 / $79.43	Professional	26	$19.50	$28.18	$79.43
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $3.72 / $6.46 / $48.98	Professional	TC	$3.72	$6.46	$48.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $66.07 / $194.98	Professional		$53.70	$66.07	$194.98
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $52.48 / $79.43	Professional	26	$39.81	$52.48	$79.43
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $6.31 / $10.00 / $112.20	Professional	TC	$6.31	$10.00	$112.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $4.68 / $23.99 / $50.12	Professional		$4.68	$23.99	$50.12
United Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $33.11 / $69.18	Professional		$23.44	$33.11	$69.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $26.92 / $47.86	Professional	26	$18.62	$26.92	$47.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.72 / $5.25 / $38.90	Professional	TC	$3.72	$5.25	$38.90
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $42.66 / $46.77	Professional		$33.88	$42.66	$46.77
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $35.48 / $38.90	Professional	26	$28.18	$35.48	$38.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $5.89 / $7.41 / $8.13	Professional	TC	$5.89	$7.41	$8.13