Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.01 / $8.22 / $13.29	Facility	26	$5.01	$8.22	$13.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.14 / $40.34 / $163.83	Professional		$23.14	$40.34	$163.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.95 / $4.33 / $26.00	Professional	26	$2.95	$4.33	$26.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.93 / $13.62 / $20.21	Professional	52	$10.93	$13.62	$20.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.91 / $27.28 / $51.83	Professional	TC	$19.91	$27.28	$51.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.29 / $60.19 / $128.80	Professional		$35.29	$60.19	$128.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $4.67 / $7.70 / $12.25	Professional	26	$4.67	$7.70	$12.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.34 / $52.34 / $141.33	Professional	TC	$31.34	$52.34	$141.33
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $20.28 / $36.67 / $279.18	Professional		$20.28	$36.67	$279.18
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $2.85 / $4.70 / $35.19	Professional	26	$2.85	$4.70	$35.19
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $16.73 / $29.28 / $247.18	Professional	TC	$16.73	$29.28	$247.18
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $101.15 / $101.15 / $101.15	Facility	26	$101.15	$101.15	$101.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.16 / $63.71 / $724.06	Professional		$26.16	$63.71	$724.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $3.50 / $6.17 / $289.41	Professional	26	$3.50	$6.17	$289.41
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.01 / $53.72 / $660.75	Professional	TC	$22.01	$53.72	$660.75
Midlands Facility/Professional Professional Modifier Low / Median / High Price $37.24 / $51.15 / $169.00	Professional		$37.24	$51.15	$169.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.36 / $21.90 / $39.68	Professional		$3.36	$21.90	$39.68
United Facility/Professional Professional Modifier Low / Median / High Price $24.31 / $36.79 / $74.70	Professional		$24.31	$36.79	$74.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.28 / $5.09 / $9.02	Professional	26	$3.28	$5.09	$9.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.97 / $43.15 / $71.42	Professional	TC	$21.97	$43.15	$71.42
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $35.86 / $45.40 / $53.40	Professional		$35.86	$45.40	$53.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $4.74 / $6.00 / $7.10	Professional	26	$4.74	$6.00	$7.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $31.13 / $39.40 / $46.30	Professional	TC	$31.13	$39.40	$46.30