Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.16 / $26.90 / $26.90	Facility	26	$14.16	$26.90	$26.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.79 / $68.86 / $273.00	Professional		$35.79	$68.86	$273.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.63 / $16.04 / $68.62	Professional	26	$9.63	$16.04	$68.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.08 / $37.79 / $98.89	Professional	TC	$26.08	$37.79	$98.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.72 / $89.84 / $125.37	Professional		$47.72	$89.84	$125.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.12 / $23.16 / $31.33	Professional	26	$12.12	$23.16	$31.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.10 / $66.36 / $91.18	Professional	TC	$36.10	$66.36	$91.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $36.61 / $63.13 / $178.76	Professional		$36.61	$63.13	$178.76
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.80 / $16.89 / $42.12	Professional	26	$9.80	$16.89	$42.12
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $24.69 / $39.72 / $128.37	Professional	TC	$24.69	$39.72	$128.37
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $23.82 / $100.00 / $100.00	Facility	26	$23.82	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $63.71 / $103.49 / $632.00	Professional		$63.71	$103.49	$632.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $14.77 / $24.40 / $223.21	Professional	26	$14.77	$24.40	$223.21
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $46.92 / $79.38 / $259.02	Professional	TC	$46.92	$79.38	$259.02
Midlands Facility/Professional Professional Modifier Low / Median / High Price $72.78 / $102.09 / $125.37	Professional		$72.78	$102.09	$125.37
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.74 / $39.70 / $71.36	Professional		$10.74	$39.70	$71.36
United Facility/Professional Professional Modifier Low / Median / High Price $60.27 / $88.08 / $147.53	Professional		$60.27	$88.08	$147.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $20.54 / $33.99	Professional	26	$14.13	$20.54	$33.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.25 / $67.54 / $111.71	Professional	TC	$46.25	$67.54	$111.71
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $58.30 / $73.80 / $86.80	Professional		$58.30	$73.80	$86.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $14.93 / $18.89 / $22.30	Professional	26	$14.93	$18.89	$22.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $43.29 / $54.80 / $64.50	Professional	TC	$43.29	$54.80	$64.50