Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $23.44 / $31.62	Facility	26	$7.94	$23.44	$31.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $23.44 / $125.89	Professional	26	$5.01	$23.44	$125.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $25.70 / $208.93	Professional	TC	$17.38	$25.70	$208.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $51.29 / $64.57	Professional	26	$25.70	$51.29	$64.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $165.96 / $208.93	Professional	TC	$69.18	$165.96	$208.93
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $30.20 / $63.10	Professional	26	$23.99	$30.20	$63.10
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $85.11 / $112.20	Professional	TC	$67.61	$85.11	$112.20
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $109.65 / $109.65	Facility	26	$57.54	$109.65	$109.65
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $147.91 / $147.91	Professional	26	$147.91	$147.91	$147.91
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $389.05 / $389.05	Professional	TC	$389.05	$389.05	$389.05
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $16.98 / $93.33	Professional	26	$12.88	$16.98	$93.33
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $48.98 / $281.84	Professional	TC	$38.90	$48.98	$281.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $37.15 / $52.48	Professional	26	$25.70	$37.15	$52.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $144.54 / $173.78	Professional	TC	$81.28	$144.54	$173.78
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $48.98 / $57.54	Professional	26	$38.90	$48.98	$57.54
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $151.36 / $177.83	Professional	TC	$120.23	$151.36	$177.83