Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $28.84 / $40.74	Professional		$21.88	$28.84	$40.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $23.99 / $32.36	Professional	26	$19.05	$23.99	$32.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $2.00 / $3.98 / $6.03	Professional	TC	$2.00	$3.98	$6.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $54.95 / $83.18	Professional		$21.38	$54.95	$83.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $38.02 / $61.66	Professional	26	$18.62	$38.02	$61.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $2.88 / $6.61 / $57.54	Professional	TC	$2.88	$6.61	$57.54
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $33.11 / $138.04	Professional		$21.38	$33.11	$138.04
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $25.70 / $112.20	Professional	26	$18.62	$25.70	$112.20
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.69 / $4.07 / $48.98	Professional	TC	$2.69	$4.07	$48.98
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $57.54 / $57.54	Facility	26	$57.54	$57.54	$57.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $50.12 / $123.03	Professional		$27.54	$50.12	$123.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $32.36 / $77.62	Professional	26	$20.89	$32.36	$77.62
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $3.72 / $6.46 / $57.54	Professional	TC	$3.72	$6.46	$57.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $75.86 / $194.98	Professional		$61.66	$75.86	$194.98
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $61.66 / $72.44	Professional	26	$33.88	$61.66	$72.44
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $4.90 / $10.00 / $131.83	Professional	TC	$4.90	$10.00	$131.83
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $4.37 / $27.54 / $57.54	Professional		$4.37	$27.54	$57.54
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $38.90 / $74.13	Professional		$26.92	$38.90	$74.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $30.20 / $57.54	Professional	26	$20.89	$30.20	$57.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.55 / $5.13 / $45.71	Professional	TC	$3.55	$5.13	$45.71
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $48.98 / $53.70	Professional		$38.90	$48.98	$53.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $41.69 / $45.71	Professional	26	$33.11	$41.69	$45.71
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $5.37 / $6.76 / $7.41	Professional	TC	$5.37	$6.76	$7.41