Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.74 / $103.78 / $177.92	Facility	26	$58.74	$103.78	$177.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.13 / $99.16 / $352.63	Professional		$66.13	$99.16	$352.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.75 / $50.69 / $212.90	Professional	26	$34.75	$50.69	$212.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.57 / $34.14 / $154.08	Professional	TC	$23.57	$34.14	$154.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.72 / $147.94 / $192.16	Professional		$107.72	$147.94	$192.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.22 / $84.29 / $114.81	Professional	26	$57.22	$84.29	$114.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.07 / $74.68 / $95.46	Professional	TC	$41.07	$74.68	$95.46
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $63.17 / $90.53 / $219.17	Professional		$63.17	$90.53	$219.17
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.09 / $44.56 / $106.98	Professional	26	$33.09	$44.56	$106.98
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.08 / $40.85 / $79.17	Professional	TC	$30.08	$40.85	$79.17
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $83.68 / $176.34 / $176.34	Facility	26	$83.68	$176.34	$176.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $72.48 / $135.04 / $568.04	Professional		$72.48	$135.04	$568.04
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $42.57 / $80.13 / $234.92	Professional	26	$42.57	$80.13	$234.92
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.25 / $42.93 / $244.63	Professional	TC	$26.25	$42.93	$244.63
Midlands Facility/Professional Professional Modifier Low / Median / High Price $97.92 / $132.61 / $181.57	Professional		$97.92	$132.61	$181.57
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.86 / $63.64 / $126.82	Professional		$33.86	$63.64	$126.82
United Facility/Professional Professional Modifier Low / Median / High Price $69.33 / $103.04 / $171.44	Professional		$69.33	$103.04	$171.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.72 / $70.23 / $100.69	Professional	26	$40.72	$70.23	$100.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.51 / $41.62 / $69.97	Professional	TC	$25.51	$41.62	$69.97
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $111.79 / $141.50 / $166.40	Professional		$111.79	$141.50	$166.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $55.85 / $70.70 / $83.20	Professional	26	$55.85	$70.70	$83.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $55.85 / $70.70 / $83.20	Professional	TC	$55.85	$70.70	$83.20