Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.73 / $58.38 / $58.38	Facility	26	$30.73	$58.38	$58.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.70 / $46.15 / $155.00	Professional		$31.70	$46.15	$155.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.17 / $23.85 / $100.00	Professional	26	$20.17	$23.85	$100.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.67 / $17.42 / $88.74	Professional	52	$13.67	$17.42	$88.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.07 / $12.55 / $29.29	Professional	TC	$9.07	$12.55	$29.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.75 / $71.19 / $88.98	Professional		$35.75	$71.19	$88.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.96 / $44.67 / $55.83	Professional	26	$23.96	$44.67	$55.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.64 / $26.52 / $33.15	Professional	TC	$12.64	$26.52	$33.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $34.46 / $49.56 / $151.59	Professional		$34.46	$49.56	$151.59
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.28 / $28.47 / $88.55	Professional	26	$22.28	$28.47	$88.55
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $11.41 / $15.69 / $57.09	Professional	TC	$11.41	$15.69	$57.09
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $51.77 / $98.42 / $98.42	Facility	26	$51.77	$98.42	$98.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $37.13 / $65.73 / $209.51	Professional		$37.13	$65.73	$209.51
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $25.87 / $41.16 / $138.46	Professional	26	$25.87	$41.16	$138.46
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $11.09 / $18.12 / $71.05	Professional	TC	$11.09	$18.12	$71.05
Midlands Facility/Professional Professional Modifier Low / Median / High Price $61.81 / $70.59 / $85.95	Professional		$61.81	$70.59	$85.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.77 / $34.74 / $62.71	Professional		$14.77	$34.74	$62.71
United Facility/Professional Professional Modifier Low / Median / High Price $35.40 / $51.49 / $85.17	Professional		$35.40	$51.49	$85.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.11 / $36.07 / $59.66	Professional	26	$24.11	$36.07	$59.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.83 / $16.00 / $26.22	Professional	TC	$10.83	$16.00	$26.22
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $51.27 / $64.90 / $76.40	Professional		$51.27	$64.90	$76.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $32.39 / $41.00 / $48.20	Professional	26	$32.39	$41.00	$48.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $18.96 / $24.00 / $28.20	Professional	TC	$18.96	$24.00	$28.20