Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.39 / $129.09 / $239.00	Facility	26	$80.39	$129.09	$239.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.95 / $98.04 / $159.49	Professional		$88.95	$98.04	$159.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.64 / $38.02 / $65.17	Professional	26	$34.64	$38.02	$65.17
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.31 / $128.04 / $131.77	Facility	26	$124.31	$128.04	$131.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.02 / $262.19 / $327.73	Professional		$113.02	$262.19	$327.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.09 / $96.19 / $129.10	Professional	26	$44.09	$96.19	$129.10
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $98.42 / $162.04 / $312.70	Professional		$98.42	$162.04	$312.70
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.84 / $62.39 / $125.83	Professional	26	$38.84	$62.39	$125.83
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $128.04 / $189.21 / $189.21	Facility	26	$128.04	$189.21	$189.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $100.78 / $179.34 / $683.45	Professional		$100.78	$179.34	$683.45
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $41.79 / $53.89 / $282.35	Professional	26	$41.79	$53.89	$282.35
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $128.04 / $131.77 / $230.46	Facility	26	$128.04	$131.77	$230.46
Midlands Facility/Professional Professional Modifier Low / Median / High Price $174.23 / $214.60 / $373.89	Professional		$174.23	$214.60	$373.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $148.69 / $148.69 / $261.10	Professional		$148.69	$148.69	$261.10
United Facility/Professional Professional Modifier Low / Median / High Price $100.78 / $124.60 / $203.98	Professional		$100.78	$124.60	$203.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.49 / $52.29 / $86.77	Professional	26	$41.49	$52.29	$86.77
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $151.13 / $191.30 / $225.00	Professional		$151.13	$191.30	$225.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $56.41 / $71.40 / $84.00	Professional	26	$56.41	$71.40	$84.00