Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.52 / $65.58 / $105.98	Facility	26	$34.52	$65.58	$105.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.62 / $132.88 / $480.00	Professional		$95.62	$132.88	$480.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.34 / $34.52 / $155.72	Professional	26	$23.34	$34.52	$155.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $70.31 / $86.57 / $137.19	Professional	TC	$70.31	$86.57	$137.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.21 / $238.25 / $363.02	Professional		$127.21	$238.25	$363.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.08 / $61.38 / $96.22	Professional	26	$33.08	$61.38	$96.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $94.13 / $176.87 / $266.81	Professional	TC	$94.13	$176.87	$266.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $87.14 / $142.88 / $363.69	Professional		$87.14	$142.88	$363.69
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.84 / $37.54 / $100.00	Professional	26	$22.84	$37.54	$100.00
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $62.15 / $97.37 / $277.02	Professional	TC	$62.15	$97.37	$277.02
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $136.00 / $136.00 / $136.00	Facility	26	$136.00	$136.00	$136.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $104.62 / $197.20 / $698.76	Professional		$104.62	$197.20	$698.76
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $27.67 / $46.90 / $279.51	Professional	26	$27.67	$46.90	$279.51
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $74.34 / $130.36 / $479.00	Professional	TC	$74.34	$130.36	$479.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $166.05 / $227.54 / $272.62	Professional		$166.05	$227.54	$272.62
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $24.53 / $89.23 / $171.84	Professional		$24.53	$89.23	$171.84
United Facility/Professional Professional Modifier Low / Median / High Price $100.69 / $144.63 / $262.93	Professional		$100.69	$144.63	$262.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.35 / $40.67 / $78.98	Professional	26	$26.35	$40.67	$78.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.98 / $103.12 / $190.99	Professional	TC	$73.98	$103.12	$190.99
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $153.88 / $194.80 / $229.20	Professional		$153.88	$194.80	$229.20
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 $115.42 / $146.10 / $171.90	Professional	TC	$115.42	$146.10	$171.90