Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.21 / $89.50 / $89.50	Facility	26	$31.21	$89.50	$89.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.04 / $121.05 / $506.52	Professional		$65.04	$121.05	$506.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.19 / $34.39 / $52.84	Professional	26	$31.19	$34.39	$52.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.33 / $67.50 / $95.46	Professional	TC	$36.33	$67.50	$95.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.55 / $214.26 / $267.82	Professional		$97.55	$214.26	$267.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.00 / $74.81 / $88.87	Professional	26	$60.00	$74.81	$88.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.18 / $144.47 / $180.58	Professional	TC	$46.18	$144.47	$180.58
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $82.13 / $119.24 / $286.27	Professional		$82.13	$119.24	$286.27
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.27 / $50.46 / $107.53	Professional	26	$31.27	$50.46	$107.53
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $66.44 / $178.75	Professional	TC	$34.67	$66.44	$178.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $82.42 / $174.47 / $687.40	Professional		$82.42	$174.47	$687.40
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $43.21 / $78.73 / $224.56	Professional	26	$43.21	$78.73	$224.56
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $41.16 / $101.49 / $472.45	Professional	TC	$41.16	$101.49	$472.45
Midlands Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $160.07 / $251.92	Professional		$90.00	$160.07	$251.92
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $34.11 / $98.59 / $181.27	Professional		$34.11	$98.59	$181.27
United Facility/Professional Professional Modifier Low / Median / High Price $89.97 / $161.97 / $240.85	Professional		$89.97	$161.97	$240.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.17 / $58.67 / $92.64	Professional	26	$39.17	$58.67	$92.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.64 / $87.18 / $146.58	Professional	TC	$49.64	$87.18	$146.58
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $160.21 / $202.80 / $238.60	Professional		$160.21	$202.80	$238.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $53.25 / $67.40 / $79.30	Professional	26	$53.25	$67.40	$79.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $107.05 / $135.50 / $159.40	Professional	TC	$107.05	$135.50	$159.40