Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.95 / $48.62 / $89.50	Facility	26	$23.95	$48.62	$89.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.31 / $86.50 / $119.13	Professional		$77.31	$86.50	$119.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.45 / $14.18 / $19.96	Professional	26	$12.45	$14.18	$19.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.49 / $50.97 / $52.46	Facility	26	$49.49	$50.97	$52.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $220.70 / $303.49	Professional		$81.28	$220.70	$303.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.07 / $34.13 / $42.66	Professional	26	$16.07	$34.13	$42.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $88.68 / $125.93 / $177.65	Professional		$88.68	$125.93	$177.65
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.06 / $22.94 / $32.99	Professional	26	$14.06	$22.94	$32.99
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $110.00 / $141.91 / $141.91	Facility	26	$110.00	$141.91	$141.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $82.23 / $134.03 / $611.40	Professional		$82.23	$134.03	$611.40
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.16 / $19.07 / $163.46	Professional	26	$15.16	$19.07	$163.46
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $50.97 / $52.46 / $83.88	Facility	26	$50.97	$52.46	$83.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $117.22 / $191.68 / $250.46	Professional		$117.22	$191.68	$250.46
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $138.60 / $138.60 / $246.00	Professional		$138.60	$138.60	$246.00
United Facility/Professional Professional Modifier Low / Median / High Price $78.12 / $98.74 / $176.38	Professional		$78.12	$98.74	$176.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.65 / $19.07 / $34.03	Professional	26	$14.65	$19.07	$34.03
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $138.96 / $175.90 / $206.90	Professional		$138.96	$175.90	$206.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $20.30 / $25.70 / $30.20	Professional	26	$20.30	$25.70	$30.20