Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.99 / $59.37 / $124.15	Facility	26	$40.99	$59.37	$124.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.53 / $72.12 / $270.00	Professional		$47.53	$72.12	$270.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.74 / $35.36 / $139.29	Professional	26	$23.74	$35.36	$139.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.67 / $32.89 / $148.30	Professional	TC	$18.67	$32.89	$148.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.93 / $123.53 / $160.93	Professional		$89.93	$123.53	$160.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.60 / $54.47 / $73.56	Professional	26	$37.60	$54.47	$73.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.79 / $71.88 / $89.85	Professional	TC	$39.79	$71.88	$89.85
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $52.03 / $74.87 / $153.41	Professional		$52.03	$74.87	$153.41
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.08 / $32.32 / $71.00	Professional	26	$23.08	$32.32	$71.00
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.95 / $39.31 / $63.22	Professional	TC	$28.95	$39.31	$63.22
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $58.37 / $118.83 / $118.83	Facility	26	$58.37	$118.83	$118.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $56.08 / $96.55 / $398.18	Professional		$56.08	$96.55	$398.18
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $29.85 / $54.12 / $160.04	Professional	26	$29.85	$54.12	$160.04
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.32 / $40.69 / $238.14	Professional	TC	$23.32	$40.69	$238.14
Midlands Facility/Professional Professional Modifier Low / Median / High Price $62.66 / $96.55 / $145.38	Professional		$62.66	$96.55	$145.38
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $25.14 / $53.51 / $104.87	Professional		$25.14	$53.51	$104.87
United Facility/Professional Professional Modifier Low / Median / High Price $55.55 / $81.56 / $137.13	Professional		$55.55	$81.56	$137.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.55 / $41.52 / $69.81	Professional	26	$28.55	$41.52	$69.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.32 / $40.04 / $67.33	Professional	TC	$23.32	$40.04	$67.33
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $92.75 / $117.40 / $138.19	Professional		$92.75	$117.40	$138.19
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $39.03 / $49.40 / $58.10	Professional	26	$39.03	$49.40	$58.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $53.80 / $68.09 / $80.09	Professional	TC	$53.80	$68.09	$80.09