Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.09 / $48.42 / $88.10	Facility	26	$29.09	$48.42	$88.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.95 / $59.36 / $231.57	Professional		$40.95	$59.36	$231.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.79 / $24.92 / $98.80	Professional	26	$16.79	$24.92	$98.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.17 / $29.48 / $132.77	Professional	TC	$17.17	$29.48	$132.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.92 / $100.50 / $132.11	Professional		$70.92	$100.50	$132.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.87 / $39.97 / $55.77	Professional	26	$28.87	$39.97	$55.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.22 / $64.90 / $81.13	Professional	TC	$35.22	$64.90	$81.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $42.35 / $61.15 / $138.81	Professional		$42.35	$61.15	$138.81
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.23 / $22.54 / $57.15	Professional	26	$16.23	$22.54	$57.15
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.11 / $35.47 / $61.64	Professional	TC	$26.11	$35.47	$61.64
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $41.24 / $98.31 / $98.31	Facility	26	$41.24	$98.31	$98.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $46.10 / $78.00 / $351.65	Professional		$46.10	$78.00	$351.65
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $21.18 / $39.69 / $131.37	Professional	26	$21.18	$39.69	$131.37
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.20 / $36.86 / $214.27	Professional	TC	$21.20	$36.86	$214.27
Midlands Facility/Professional Professional Modifier Low / Median / High Price $54.51 / $77.76 / $118.33	Professional		$54.51	$77.76	$118.33
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $17.85 / $44.69 / $85.36	Professional		$17.85	$44.69	$85.36
United Facility/Professional Professional Modifier Low / Median / High Price $44.91 / $65.33 / $108.06	Professional		$44.91	$65.33	$108.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.26 / $34.13 / $50.10	Professional	26	$20.26	$34.13	$50.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.20 / $35.86 / $59.31	Professional	TC	$21.20	$35.86	$59.31
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $75.92 / $96.10 / $113.00	Professional		$75.92	$96.10	$113.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $27.41 / $34.70 / $40.79	Professional	26	$27.41	$34.70	$40.79
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $48.51 / $61.40 / $72.20	Professional	TC	$48.51	$61.40	$72.20