Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.02 / $3.02 / $3.02	Facility	26	$3.02	$3.02	$3.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $21.88 / $40.74	Professional		$12.88	$21.88	$40.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.00 / $3.98 / $12.30	Professional	26	$2.00	$3.98	$12.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $15.85 / $31.62	Professional	TC	$10.96	$15.85	$31.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $31.62 / $45.71	Professional		$17.78	$31.62	$45.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.47 / $6.17 / $9.33	Professional	26	$3.47	$6.17	$9.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $26.30 / $36.31	Professional	TC	$14.45	$26.30	$36.31
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $28.84 / $60.26	Professional		$13.80	$28.84	$60.26
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $2.45 / $7.59 / $12.59	Professional	26	$2.45	$7.59	$12.59
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $11.22 / $19.05 / $46.77	Professional	TC	$11.22	$19.05	$46.77
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $5.89 / $100.00 / $100.00	Facility	26	$5.89	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $38.90 / $162.18	Professional		$22.91	$38.90	$162.18
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $4.68 / $8.51 / $53.70	Professional	26	$4.68	$8.51	$53.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $30.20 / $128.82	Professional	TC	$17.78	$30.20	$128.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $40.74 / $51.29	Professional		$35.48	$40.74	$51.29
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $8.51 / $10.96	Professional	26	$6.31	$8.51	$10.96
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $32.36 / $40.74	Professional	TC	$28.18	$32.36	$40.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $45.71 / $50.12	Professional		$26.92	$45.71	$50.12
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $10.00 / $11.48	Professional	26	$7.24	$10.00	$11.48
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $36.31 / $38.02	Professional	TC	$17.78	$36.31	$38.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.09 / $15.85 / $33.11	Professional		$3.09	$15.85	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $32.36 / $54.95	Professional		$21.38	$32.36	$54.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $4.47 / $7.24 / $12.02	Professional	26	$4.47	$7.24	$12.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $25.70 / $43.65	Professional	TC	$16.98	$25.70	$43.65
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $28.18 / $33.11	Professional		$22.39	$28.18	$33.11
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $3.98 / $5.01 / $5.89	Professional	26	$3.98	$5.01	$5.89
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $23.44 / $27.54	Professional	TC	$18.62	$23.44	$27.54