Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.08 / $27.59 / $40.11	Professional		$24.08	$27.59	$40.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.37 / $23.78 / $34.53	Professional	26	$21.37	$23.78	$34.53
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.04 / $13.80 / $20.05	Professional	52	$12.04	$13.80	$20.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $2.70 / $4.09 / $5.58	Professional	TC	$2.70	$4.09	$5.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.33 / $61.09 / $102.00	Professional		$23.33	$61.09	$102.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.94 / $41.91 / $64.56	Professional	26	$19.94	$41.91	$64.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.24 / $6.81 / $69.00	Professional	TC	$3.24	$6.81	$69.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $21.26 / $34.22 / $138.75	Professional		$21.26	$34.22	$138.75
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.51 / $25.80 / $111.56	Professional	26	$18.51	$25.80	$111.56
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.75 / $4.55 / $59.93	Professional	TC	$2.75	$4.55	$59.93
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $57.67 / $57.67 / $112.04	Facility	26	$57.67	$57.67	$112.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.76 / $46.02 / $192.43	Professional		$28.76	$46.02	$192.43
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $20.92 / $32.50 / $76.98	Professional	26	$20.92	$32.50	$76.98
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $3.69 / $5.64 / $56.53	Professional	TC	$3.69	$5.64	$56.53
Midlands Facility/Professional Professional Modifier Low / Median / High Price $41.97 / $61.96 / $102.00	Professional		$41.97	$61.96	$102.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $4.29 / $26.45 / $49.48	Professional		$4.29	$26.45	$49.48
United Facility/Professional Professional Modifier Low / Median / High Price $27.32 / $39.11 / $70.95	Professional		$27.32	$39.11	$70.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.76 / $34.00 / $64.50	Professional	26	$21.76	$34.00	$64.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.69 / $5.49 / $21.62	Professional	TC	$3.69	$5.49	$21.62
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $38.54 / $48.80 / $50.70	Professional		$38.54	$48.80	$50.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $33.18 / $42.00 / $43.70	Professional	26	$33.18	$42.00	$43.70
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $5.37 / $6.80 / $7.10	Professional	TC	$5.37	$6.80	$7.10