Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.08 / $35.46 / $69.92	Facility	26	$23.08	$35.46	$69.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.55 / $55.08 / $278.58	Professional		$42.55	$55.08	$278.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.62 / $16.85 / $79.93	Professional	26	$13.62	$16.85	$79.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.86 / $38.44 / $198.65	Professional	TC	$28.86	$38.44	$198.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.56 / $105.69 / $136.69	Professional		$67.56	$105.69	$136.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.65 / $32.76 / $43.74	Professional	26	$21.65	$32.76	$43.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.91 / $71.31 / $98.25	Professional	TC	$45.91	$71.31	$98.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $36.43 / $52.17 / $173.51	Professional		$36.43	$52.17	$173.51
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $17.85 / $42.69	Professional	26	$12.88	$17.85	$42.69
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.56 / $35.43 / $110.61	Professional	TC	$23.56	$35.43	$110.61
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $32.90 / $80.00 / $80.00	Facility	26	$32.90	$80.00	$80.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $57.96 / $106.73 / $541.00	Professional		$57.96	$106.73	$541.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $17.18 / $31.39 / $91.83	Professional	26	$17.18	$31.39	$91.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $38.57 / $70.69 / $217.68	Professional	TC	$38.57	$70.69	$217.68
Midlands Facility/Professional Professional Modifier Low / Median / High Price $78.84 / $105.02 / $134.78	Professional		$78.84	$105.02	$134.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.73 / $37.60 / $73.40	Professional		$13.73	$37.60	$73.40
United Facility/Professional Professional Modifier Low / Median / High Price $53.33 / $87.62 / $131.87	Professional		$53.33	$87.62	$131.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.44 / $25.55 / $40.19	Professional	26	$16.44	$25.55	$40.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.89 / $60.54 / $91.23	Professional	TC	$36.89	$60.54	$91.23
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $65.33 / $82.70 / $97.30	Professional		$65.33	$82.70	$97.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $21.65 / $27.40 / $32.20	Professional	26	$21.65	$27.40	$32.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $43.77 / $55.40 / $65.20	Professional	TC	$43.77	$55.40	$65.20