Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.41 / $21.37 / $21.37	Facility	26	$7.41	$21.37	$21.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.82 / $45.24 / $169.00	Professional		$24.82	$45.24	$169.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $47.07 / $47.07 / $47.07	Professional	25	$47.07	$47.07	$47.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.71 / $11.25 / $37.00	Professional	26	$7.71	$11.25	$37.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.11 / $24.81 / $71.54	Professional	TC	$17.11	$24.81	$71.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.79 / $57.35 / $76.70	Professional		$31.79	$57.35	$76.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.60 / $16.05 / $20.65	Professional	26	$8.60	$16.05	$20.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.56 / $41.06 / $56.58	Professional	TC	$22.56	$41.06	$56.58
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $25.62 / $40.26 / $123.03	Professional		$25.62	$40.26	$123.03
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.79 / $12.27 / $32.00	Professional	26	$7.79	$12.27	$32.00
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.50 / $26.12 / $84.31	Professional	TC	$17.50	$26.12	$84.31
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $18.87 / $100.00 / $100.00	Facility	26	$18.87	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $37.90 / $64.93 / $400.00	Professional		$37.90	$64.93	$400.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.49 / $16.57 / $132.09	Professional	26	$9.49	$16.57	$132.09
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $27.43 / $46.45 / $135.32	Professional	TC	$27.43	$46.45	$135.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $50.84 / $66.73 / $76.70	Professional		$50.84	$66.73	$76.70
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $27.69 / $49.43	Professional		$8.71	$27.69	$49.43
United Facility/Professional Professional Modifier Low / Median / High Price $36.26 / $53.05 / $89.65	Professional		$36.26	$53.05	$89.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.08 / $13.20 / $21.83	Professional	26	$9.08	$13.20	$21.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.06 / $39.54 / $65.40	Professional	TC	$27.06	$39.54	$65.40
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $40.84 / $51.70 / $60.80	Professional		$40.84	$51.70	$60.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $11.93 / $15.10 / $17.80	Professional	26	$11.93	$15.10	$17.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $28.91 / $36.60 / $43.00	Professional	TC	$28.91	$36.60	$43.00