Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.68 / $98.19 / $158.66	Facility	26	$51.68	$98.19	$158.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.08 / $95.18 / $330.00	Professional		$72.08	$95.18	$330.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.97 / $43.26 / $204.23	Professional	26	$32.97	$43.26	$204.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.57 / $39.69 / $179.28	Professional	TC	$23.57	$39.69	$179.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.90 / $163.31 / $217.05	Professional		$118.90	$163.31	$217.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.87 / $84.55 / $118.09	Professional	26	$54.87	$84.55	$118.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.56 / $87.94 / $109.92	Professional	TC	$47.56	$87.94	$109.92
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $68.91 / $98.61 / $215.52	Professional		$68.91	$98.61	$215.52
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.72 / $46.77 / $123.00	Professional	26	$33.72	$46.77	$123.00
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.19 / $47.75 / $69.12	Professional	TC	$35.19	$47.75	$69.12
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $85.71 / $174.72 / $174.72	Facility	26	$85.71	$174.72	$174.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.92 / $131.38 / $568.04	Professional		$75.92	$131.38	$568.04
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $43.78 / $79.43 / $236.22	Professional	26	$43.78	$79.43	$236.22
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.57 / $49.70 / $285.88	Professional	TC	$28.57	$49.70	$285.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $87.18 / $135.33 / $210.17	Professional		$87.18	$135.33	$210.17
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $36.47 / $68.44 / $138.05	Professional		$36.47	$68.44	$138.05
United Facility/Professional Professional Modifier Low / Median / High Price $75.17 / $109.34 / $183.83	Professional		$75.17	$109.34	$183.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.88 / $70.98 / $103.55	Professional	26	$41.88	$70.98	$103.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.62 / $48.43 / $80.11	Professional	TC	$28.62	$48.43	$80.11
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $122.29 / $154.80 / $182.10	Professional		$122.29	$154.80	$182.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $56.96 / $72.09 / $84.80	Professional	26	$56.96	$72.09	$84.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $65.33 / $82.70 / $97.30	Professional	TC	$65.33	$82.70	$97.30