Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.31 / $37.84 / $37.84	Facility	26	$22.31	$37.84	$37.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.86 / $48.18 / $170.00	Professional		$33.86	$48.18	$170.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.72 / $15.35 / $60.76	Professional	26	$11.72	$15.35	$60.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.69 / $27.61 / $64.76	Professional	TC	$19.69	$27.61	$64.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.63 / $81.65 / $102.07	Professional		$39.63	$81.65	$102.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.03 / $28.61 / $37.22	Professional	26	$15.03	$28.61	$37.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.22 / $53.04 / $66.30	Professional	TC	$24.22	$53.04	$66.30
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $36.64 / $53.55 / $112.61	Professional		$36.64	$53.55	$112.61
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.79 / $21.58 / $41.56	Professional	26	$13.79	$21.58	$41.56
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.52 / $32.04 / $70.09	Professional	TC	$21.52	$32.04	$70.09
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $33.53 / $100.00 / $100.00	Facility	26	$33.53	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.36 / $77.06 / $348.00	Professional		$40.36	$77.06	$348.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $16.80 / $29.22 / $89.60	Professional	26	$16.80	$29.22	$89.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.30 / $43.79 / $198.00	Professional	TC	$24.30	$43.79	$198.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $48.44 / $77.76 / $100.89	Professional		$48.44	$77.76	$100.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.80 / $38.77 / $70.33	Professional		$14.80	$38.77	$70.33
United Facility/Professional Professional Modifier Low / Median / High Price $40.36 / $58.72 / $97.13	Professional		$40.36	$58.72	$97.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.07 / $24.26 / $39.74	Professional	26	$16.07	$24.26	$39.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.30 / $35.34 / $58.46	Professional	TC	$24.30	$35.34	$58.46
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 $20.94 / $26.50 / $31.20	Professional	26	$20.94	$26.50	$31.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $37.36 / $47.30 / $55.60	Professional	TC	$37.36	$47.30	$55.60