Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.86 / $50.17 / $106.02	Professional		$34.86	$50.17	$106.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.08 / $13.25 / $38.72	Professional	26	$10.08	$13.25	$38.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.37 / $36.40 / $76.89	Professional	TC	$21.37	$36.40	$76.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.97 / $92.82 / $116.03	Professional		$44.97	$92.82	$116.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.27 / $24.43 / $31.33	Professional	26	$13.27	$24.43	$31.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.03 / $68.39 / $85.49	Professional	TC	$31.03	$68.39	$85.49
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $40.50 / $59.57 / $133.72	Professional		$40.50	$59.57	$133.72
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $15.43 / $37.95	Professional	26	$11.48	$15.43	$37.95
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.37 / $41.33 / $80.29	Professional	TC	$29.37	$41.33	$80.29
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $28.55 / $80.00 / $80.00	Facility	26	$28.55	$80.00	$80.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $45.84 / $77.39 / $251.93	Professional		$45.84	$77.39	$251.93
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $14.32 / $22.78 / $76.73	Professional	26	$14.32	$22.78	$76.73
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.54 / $48.81 / $175.19	Professional	TC	$29.54	$48.81	$175.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $58.06 / $82.89 / $107.13	Professional		$58.06	$82.89	$107.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $12.77 / $41.78 / $79.31	Professional		$12.77	$41.78	$79.31
United Facility/Professional Professional Modifier Low / Median / High Price $41.99 / $61.07 / $101.02	Professional		$41.99	$61.07	$101.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.73 / $20.09 / $33.95	Professional	26	$13.73	$20.09	$33.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.39 / $43.67 / $69.88	Professional	TC	$28.39	$43.67	$69.88
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $66.20 / $83.80 / $98.60	Professional		$66.20	$83.80	$98.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $17.93 / $22.70 / $26.70	Professional	26	$17.93	$22.70	$26.70
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $48.35 / $61.20 / $71.90	Professional	TC	$48.35	$61.20	$71.90