Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.93 / $87.50 / $161.24	Facility	26	$47.93	$87.50	$161.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.98 / $116.44 / $199.96	Professional		$104.98	$116.44	$199.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.16 / $88.74 / $91.33	Facility	26	$86.16	$88.74	$91.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.79 / $293.20 / $366.52	Professional		$117.79	$293.20	$366.52
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $108.01 / $168.27 / $248.89	Professional		$108.01	$168.27	$248.89
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.16 / $40.25 / $53.99	Professional	26	$25.16	$40.25	$53.99
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $88.74 / $122.62 / $122.62	Facility	26	$88.74	$122.62	$122.62
Medica Facility/Professional Professional Modifier Low / Median / High Price $115.00 / $184.40 / $867.22	Professional		$115.00	$184.40	$867.22
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $88.74 / $91.33 / $151.13	Facility	26	$88.74	$91.33	$151.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $181.00 / $249.13 / $382.27	Professional		$181.00	$249.13	$382.27
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $27.49 / $107.96 / $221.34	Professional		$27.49	$107.96	$221.34
United Facility/Professional Professional Modifier Low / Median / High Price $116.04 / $142.72 / $239.29	Professional		$116.04	$142.72	$239.29
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $168.27 / $213.00 / $250.50	Professional		$168.27	$213.00	$250.50