Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.70 / $46.92 / $75.83	Facility	26	$24.70	$46.92	$75.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.01 / $68.73 / $273.22	Professional		$50.01	$68.73	$273.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.10 / $24.70 / $84.24	Professional	26	$17.10	$24.70	$84.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.40 / $44.04 / $69.20	Professional	TC	$32.40	$44.04	$69.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.42 / $123.17 / $204.19	Professional		$75.42	$123.17	$204.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.37 / $43.92 / $69.31	Professional	26	$23.37	$43.92	$69.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.82 / $83.14 / $134.76	Professional	TC	$48.82	$83.14	$134.76
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $45.07 / $81.58 / $236.85	Professional		$45.07	$81.58	$236.85
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.28 / $26.86 / $164.76	Professional	26	$16.28	$26.86	$164.76
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.81 / $49.13 / $177.86	Professional	TC	$27.81	$49.13	$177.86
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $128.36 / $128.36 / $128.36	Facility	26	$128.36	$128.36	$128.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $55.74 / $115.30 / $604.11	Professional		$55.74	$115.30	$604.11
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.72 / $32.97 / $456.30	Professional	26	$19.72	$32.97	$456.30
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $35.72 / $75.93 / $388.70	Professional	TC	$35.72	$75.93	$388.70
Midlands Facility/Professional Professional Modifier Low / Median / High Price $79.98 / $108.64 / $157.00	Professional		$79.98	$108.64	$157.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $17.32 / $47.77 / $89.39	Professional		$17.32	$47.77	$89.39
United Facility/Professional Professional Modifier Low / Median / High Price $54.50 / $104.46 / $192.45	Professional		$54.50	$104.46	$192.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.03 / $27.59 / $56.50	Professional	26	$19.03	$27.59	$56.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.94 / $58.57 / $91.53	Professional	TC	$33.94	$58.57	$91.53
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $79.08 / $100.10 / $117.80	Professional		$79.08	$100.10	$117.80
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 $51.67 / $65.40 / $76.90	Professional	TC	$51.67	$65.40	$76.90