Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.36 / $65.30 / $65.30	Facility	26	$34.36	$65.30	$65.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.56 / $59.49 / $239.25	Professional		$48.56	$59.49	$239.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.23 / $29.57 / $68.58	Professional	26	$26.23	$29.57	$68.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.98 / $24.46 / $63.20	Professional	TC	$18.98	$24.46	$63.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.28 / $61.88 / $144.12	Professional		$39.28	$61.88	$144.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.29 / $39.38 / $78.06	Professional	26	$25.29	$39.38	$78.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.99 / $22.50 / $66.05	Professional	TC	$13.99	$22.50	$66.05
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $40.22 / $41.10 / $79.02	Professional		$40.22	$41.10	$79.02
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.35 / $27.24 / $79.02	Professional	26	$26.35	$27.24	$79.02
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $13.87 / $14.02 / $79.02	Professional	TC	$13.87	$14.02	$79.02
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $141.63 / $141.63 / $141.63	Facility	26	$141.63	$141.63	$141.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $57.45 / $76.98 / $240.37	Professional		$57.45	$76.98	$240.37
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $29.39 / $38.17 / $182.49	Professional	26	$29.39	$38.17	$182.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $30.31 / $151.88	Professional	TC	$23.99	$30.31	$151.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $64.05 / $87.69 / $144.12	Professional		$64.05	$87.69	$144.12
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.88 / $38.14 / $71.81	Professional		$13.88	$38.14	$71.81
United Facility/Professional Professional Modifier Low / Median / High Price $52.23 / $66.30 / $110.46	Professional		$52.23	$66.30	$110.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.31 / $36.82 / $60.88	Professional	26	$29.31	$36.82	$60.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.92 / $28.37 / $49.51	Professional	TC	$22.92	$28.37	$49.51
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $64.23 / $81.30 / $95.70	Professional		$64.23	$81.30	$95.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $41.40 / $52.40 / $61.60	Professional	26	$41.40	$52.40	$61.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $29.00 / $34.10	Professional	TC	$22.91	$29.00	$34.10