Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.55 / $34.53 / $71.31	Facility	26	$23.55	$34.53	$71.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.39 / $43.40 / $216.63	Professional		$28.39	$43.40	$216.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.93 / $19.05 / $81.92	Professional	26	$13.93	$19.05	$81.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.01 / $29.17 / $134.71	Professional	TC	$13.01	$29.17	$134.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.48 / $92.82 / $122.50	Professional		$58.48	$92.82	$122.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.34 / $29.74 / $40.63	Professional	26	$21.34	$29.74	$40.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.48 / $63.51 / $80.15	Professional	TC	$28.48	$63.51	$80.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $38.95 / $56.30 / $146.69	Professional		$38.95	$56.30	$146.69
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.40 / $18.72 / $62.34	Professional	26	$13.40	$18.72	$62.34
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.54 / $34.71 / $76.52	Professional	TC	$25.54	$34.71	$76.52
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $33.90 / $80.00 / $80.00	Facility	26	$33.90	$80.00	$80.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $37.97 / $65.81 / $306.10	Professional		$37.97	$65.81	$306.10
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $16.80 / $30.82 / $93.99	Professional	26	$16.80	$30.82	$93.99
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $16.64 / $36.36 / $212.11	Professional	TC	$16.64	$36.36	$212.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $40.33 / $65.81 / $109.03	Professional		$40.33	$65.81	$109.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.40 / $40.39 / $78.64	Professional		$14.40	$40.39	$78.64
United Facility/Professional Professional Modifier Low / Median / High Price $36.64 / $56.96 / $100.49	Professional		$36.64	$56.96	$100.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.77 / $24.38 / $40.33	Professional	26	$16.77	$24.38	$40.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.44 / $34.10 / $60.16	Professional	TC	$15.44	$34.10	$60.16
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $70.06 / $88.70 / $104.40	Professional		$70.06	$88.70	$104.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $22.67 / $28.70 / $33.79	Professional	26	$22.67	$28.70	$33.79
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $47.48 / $60.10 / $70.70	Professional	TC	$47.48	$60.10	$70.70