Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.16 / $55.40 / $89.52	Facility	26	$29.16	$55.40	$89.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.64 / $58.33 / $253.43	Professional		$32.64	$58.33	$253.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.42 / $23.99 / $114.84	Professional	26	$17.42	$23.99	$114.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.75 / $30.41 / $138.59	Professional	TC	$10.75	$30.41	$138.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.78 / $108.87 / $142.91	Professional		$68.78	$108.87	$142.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.75 / $42.48 / $56.48	Professional	26	$29.75	$42.48	$56.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.90 / $67.00 / $83.75	Professional	TC	$28.90	$67.00	$83.75
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $46.00 / $66.18 / $107.76	Professional		$46.00	$66.18	$107.76
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.04 / $25.76 / $42.48	Professional	26	$19.04	$25.76	$42.48
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.96 / $35.93 / $51.01	Professional	TC	$26.96	$35.93	$51.01
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $48.04 / $92.34 / $92.34	Facility	26	$48.04	$92.34	$92.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.78 / $75.69 / $355.02	Professional		$44.78	$75.69	$355.02
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $23.60 / $44.22 / $132.09	Professional	26	$23.60	$44.22	$132.09
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $14.44 / $37.42 / $222.93	Professional	TC	$14.44	$37.42	$222.93
Midlands Facility/Professional Professional Modifier Low / Median / High Price $46.83 / $75.69 / $128.75	Professional		$46.83	$75.69	$128.75
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $20.61 / $47.70 / $92.87	Professional		$20.61	$47.70	$92.87
United Facility/Professional Professional Modifier Low / Median / High Price $43.08 / $71.65 / $118.51	Professional		$43.08	$71.65	$118.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.53 / $34.36 / $57.54	Professional	26	$23.53	$34.36	$57.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.93 / $35.08 / $61.90	Professional	TC	$14.93	$35.08	$61.90
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $82.24 / $104.10 / $122.50	Professional		$82.24	$104.10	$122.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $32.15 / $40.70 / $47.90	Professional	26	$32.15	$40.70	$47.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $50.09 / $63.40 / $74.59	Professional	TC	$50.09	$63.40	$74.59