Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.67 / $23.95 / $34.84	Professional		$20.67	$23.95	$34.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.64 / $20.14 / $29.26	Professional	26	$17.64	$20.14	$29.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $3.02 / $4.09 / $5.58	Professional	TC	$3.02	$4.09	$5.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.05 / $53.85 / $100.00	Professional		$20.05	$53.85	$100.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.66 / $40.00 / $55.25	Professional	26	$16.66	$40.00	$55.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.39 / $7.18 / $60.00	Professional	TC	$3.39	$7.18	$60.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $18.47 / $30.05 / $144.28	Professional		$18.47	$30.05	$144.28
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $24.96 / $112.91	Professional	26	$15.49	$24.96	$112.91
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.99 / $5.09 / $51.78	Professional	TC	$2.99	$5.09	$51.78
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $48.22 / $48.22 / $100.00	Facility	26	$48.22	$48.22	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $24.56 / $42.84 / $188.57	Professional		$24.56	$42.84	$188.57
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.77 / $28.30 / $65.31	Professional	26	$19.77	$28.30	$65.31
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $3.72 / $5.94 / $48.80	Professional	TC	$3.72	$5.94	$48.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $37.26 / $54.04 / $106.98	Professional		$37.26	$54.04	$106.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $4.62 / $23.57 / $45.02	Professional		$4.62	$23.57	$45.02
United Facility/Professional Professional Modifier Low / Median / High Price $23.33 / $33.40 / $65.00	Professional		$23.33	$33.40	$65.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.20 / $26.64 / $47.65	Professional	26	$19.20	$26.64	$47.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.68 / $5.41 / $18.45	Professional	TC	$3.68	$5.41	$18.45
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $33.65 / $42.60 / $44.30	Professional		$33.65	$42.60	$44.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $27.81 / $35.20 / $36.60	Professional	26	$27.81	$35.20	$36.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $5.85 / $7.40 / $7.70	Professional	TC	$5.85	$7.40	$7.70