Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.59 / $115.54 / $201.01	Professional		$92.59	$115.54	$201.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.70 / $61.53 / $246.51	Professional	26	$41.70	$61.53	$246.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $192.87 / $216.60 / $241.52	Professional		$192.87	$216.60	$241.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.49 / $116.87 / $128.63	Professional	26	$93.49	$116.87	$128.63
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $78.45 / $141.91 / $270.67	Professional		$78.45	$141.91	$270.67
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $42.70 / $77.81 / $232.03	Professional	26	$42.70	$77.81	$232.03
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $210.41 / $210.41 / $210.41	Facility	26	$210.41	$210.41	$210.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $104.00 / $192.87 / $618.72	Professional		$104.00	$192.87	$618.72
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $49.99 / $100.82 / $320.32	Professional	26	$49.99	$100.82	$320.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $129.00 / $192.87 / $232.61	Professional		$129.00	$192.87	$232.61
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $161.19 / $214.30	Professional		$10.00	$161.19	$214.30
United Facility/Professional Professional Modifier Low / Median / High Price $88.28 / $151.55 / $239.49	Professional		$88.28	$151.55	$239.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.60 / $85.82 / $135.62	Professional	26	$49.60	$85.82	$135.62
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $170.10 / $170.10 / $200.10	Professional		$170.10	$170.10	$200.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $89.20 / $89.20 / $104.90	Professional	26	$89.20	$89.20	$104.90