Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.27 / $130.53 / $241.43	Facility	26	$73.27	$130.53	$241.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.08 / $105.50 / $170.49	Professional		$91.08	$105.50	$170.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.61 / $38.08 / $60.49	Professional	26	$34.61	$38.08	$60.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $129.29 / $133.16 / $137.05	Facility	26	$129.29	$133.16	$137.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.11 / $259.08 / $356.98	Professional		$106.11	$259.08	$356.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.94 / $89.98 / $125.15	Professional	26	$41.94	$89.98	$125.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $97.54 / $177.73 / $570.87	Professional		$97.54	$177.73	$570.87
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.82 / $59.85 / $239.07	Professional	26	$36.82	$59.85	$239.07
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $93.38 / $178.64 / $178.64	Facility	26	$93.38	$178.64	$178.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $110.65 / $199.10 / $1,963.99	Professional		$110.65	$199.10	$1,963.99
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $41.68 / $54.07 / $549.82	Professional	26	$41.68	$54.07	$549.82
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $133.16 / $137.05 / $219.48	Facility	26	$133.16	$137.05	$219.48
Midlands Facility/Professional Professional Modifier Low / Median / High Price $188.12 / $236.26 / $511.00	Professional		$188.12	$236.26	$511.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $39.90 / $84.29 / $200.40	Professional		$39.90	$84.29	$200.40
United Facility/Professional Professional Modifier Low / Median / High Price $100.59 / $130.79 / $215.77	Professional		$100.59	$130.79	$215.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.52 / $52.41 / $88.08	Professional	26	$41.52	$52.41	$88.08
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $149.78 / $189.60 / $223.00	Professional		$149.78	$189.60	$223.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $53.25 / $67.40 / $79.30	Professional	26	$53.25	$67.40	$79.30