Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.21 / $28.21 / $52.12	Facility	26	$17.21	$28.21	$52.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.61 / $11.45 / $19.32	Professional	26	$8.61	$11.45	$19.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.57 / $16.50 / $21.47	Professional	TC	$12.57	$16.50	$21.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.09 / $50.25 / $77.08	Professional	26	$24.09	$50.25	$77.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.82 / $76.06 / $108.45	Professional	TC	$33.82	$76.06	$108.45
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.00 / $31.28 / $42.21	Professional	26	$25.00	$31.28	$42.21
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.75 / $44.66 / $57.41	Professional	TC	$34.75	$44.66	$57.41
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $57.75 / $110.49 / $110.49	Facility	26	$57.75	$110.49	$110.49
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $149.40 / $149.40 / $149.40	Professional	26	$149.40	$149.40	$149.40
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $183.70 / $183.70 / $183.70	Professional	TC	$183.70	$183.70	$183.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.52 / $25.52 / $25.52	Professional	26	$25.52	$25.52	$25.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.75 / $37.75 / $37.75	Professional	TC	$37.75	$37.75	$37.75
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $38.47 / $48.70 / $57.30	Professional	26	$38.47	$48.70	$57.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $56.41 / $71.40 / $84.00	Professional	TC	$56.41	$71.40	$84.00