Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.32 / $20.67 / $68.98	Professional		$13.32	$20.67	$68.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.40 / $4.59 / $12.68	Professional	26	$2.40	$4.59	$12.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.92 / $16.07 / $56.74	Professional	TC	$10.92	$16.07	$56.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.84 / $32.92 / $49.77	Professional		$18.84	$32.92	$49.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.56 / $6.11 / $10.02	Professional	26	$3.56	$6.11	$10.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.84 / $27.68 / $38.40	Professional	TC	$14.84	$27.68	$38.40
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $22.87 / $59.71	Professional		$13.80	$22.87	$59.71
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $2.48 / $4.80 / $13.64	Professional	26	$2.48	$4.80	$13.64
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $11.17 / $17.03 / $44.22	Professional	TC	$11.17	$17.03	$44.22
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $5.94 / $100.00 / $100.00	Facility	26	$5.94	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $24.00 / $39.97 / $161.00	Professional		$24.00	$39.97	$161.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $4.88 / $8.88 / $54.00	Professional	26	$4.88	$8.88	$54.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $18.18 / $31.81 / $129.00	Professional	TC	$18.18	$31.81	$129.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $27.30 / $39.97 / $51.72	Professional		$27.30	$39.97	$51.72
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.12 / $15.52 / $27.69	Professional		$3.12	$15.52	$27.69
United Facility/Professional Professional Modifier Low / Median / High Price $22.48 / $33.35 / $55.60	Professional		$22.48	$33.35	$55.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $4.68 / $7.53 / $12.07	Professional	26	$4.68	$7.53	$12.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.80 / $27.35 / $44.04	Professional	TC	$17.80	$27.35	$44.04
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $22.44 / $28.40 / $33.40	Professional		$22.44	$28.40	$33.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $3.95 / $5.00 / $5.90	Professional	26	$3.95	$5.00	$5.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $18.41 / $23.30 / $27.40	Professional	TC	$18.41	$23.30	$27.40