Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $44.67 / $60.26	Facility	26	$30.20	$44.67	$60.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $46.77 / $154.88	Professional		$30.90	$46.77	$154.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $26.92 / $114.82	Professional	26	$19.95	$26.92	$114.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.00 / $12.02 / $30.20	Professional	TC	$10.00	$12.02	$30.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $74.13 / $91.20	Professional		$34.67	$74.13	$91.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $45.71 / $57.54	Professional	26	$23.44	$45.71	$57.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.02 / $27.54 / $33.88	Professional	TC	$12.02	$27.54	$33.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $56.23 / $151.36	Professional		$33.11	$56.23	$151.36
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $25.12 / $81.28	Professional	26	$20.89	$25.12	$81.28
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $12.88 / $35.48	Professional	TC	$10.96	$12.88	$35.48
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $97.72 / $97.72	Facility	26	$51.29	$97.72	$97.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $64.57 / $208.93	Professional		$34.67	$64.57	$208.93
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $38.90 / $138.04	Professional	26	$23.44	$38.90	$138.04
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $10.72 / $17.38 / $70.79	Professional	TC	$10.72	$17.38	$70.79
Midlands Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $75.86 / $83.18	Professional		$61.66	$75.86	$83.18
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $51.29 / $56.23	Professional	26	$42.66	$51.29	$56.23
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $25.12 / $28.84	Professional	TC	$19.05	$25.12	$28.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $83.18	Professional		$69.18	$69.18	$83.18
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $46.77 / $56.23	Professional	26	$46.77	$46.77	$56.23
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $21.38 / $28.84	Professional	TC	$21.38	$21.38	$28.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $35.48 / $74.13	Professional		$14.79	$35.48	$74.13
United Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $51.29 / $87.10	Professional		$34.67	$51.29	$87.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $36.31 / $60.26	Professional	26	$22.91	$36.31	$60.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.72 / $15.49 / $26.30	Professional	TC	$10.72	$15.49	$26.30
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $64.57 / $75.86	Professional		$51.29	$64.57	$75.86
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $40.74 / $47.86	Professional	26	$32.36	$40.74	$47.86
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $23.99 / $28.18	Professional	TC	$19.05	$23.99	$28.18