Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.03 / $48.84 / $100.04	Facility	26	$33.03	$48.84	$100.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.35 / $57.45 / $194.00	Professional		$38.35	$57.45	$194.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.14 / $24.06 / $111.85	Professional	26	$17.14	$24.06	$111.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $33.51 / $152.13	Professional	TC	$19.05	$33.51	$152.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.00 / $116.55 / $148.93	Professional		$81.00	$116.55	$148.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.98 / $42.82 / $61.02	Professional	26	$29.98	$42.82	$61.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.10 / $75.37 / $94.22	Professional	TC	$41.10	$75.37	$94.22
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $48.82 / $65.65 / $135.16	Professional		$48.82	$65.65	$135.16
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.73 / $25.44 / $55.42	Professional	26	$18.73	$25.44	$55.42
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.08 / $40.85 / $79.34	Professional	TC	$30.08	$40.85	$79.34
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $47.70 / $97.62 / $97.62	Facility	26	$47.70	$97.62	$97.62
Medica Facility/Professional Professional Modifier Low / Median / High Price $51.25 / $86.48 / $378.70	Professional		$51.25	$86.48	$378.70
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $24.05 / $43.91 / $130.11	Professional	26	$24.05	$43.91	$130.11
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.79 / $41.08 / $242.47	Professional	TC	$23.79	$41.08	$242.47
Midlands Facility/Professional Professional Modifier Low / Median / High Price $55.53 / $85.04 / $136.31	Professional		$55.53	$85.04	$136.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $50.99 / $98.32	Professional		$19.95	$50.99	$98.32
United Facility/Professional Professional Modifier Low / Median / High Price $48.99 / $74.54 / $123.31	Professional		$48.99	$74.54	$123.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.00 / $36.14 / $56.25	Professional	26	$23.00	$36.14	$56.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.23 / $41.08 / $69.84	Professional	TC	$24.23	$41.08	$69.84
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $87.53 / $110.80 / $130.30	Professional		$87.53	$110.80	$130.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $31.60 / $40.00 / $47.10	Professional	26	$31.60	$40.00	$47.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $55.85 / $70.70 / $83.20	Professional	TC	$55.85	$70.70	$83.20