Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.10 / $65.34 / $116.38	Facility	26	$54.10	$65.34	$116.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.60 / $111.88 / $212.90	Professional		$96.60	$111.88	$212.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.42 / $36.08 / $58.26	Professional	26	$21.42	$36.08	$58.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.70 / $72.81 / $74.94	Facility	26	$70.70	$72.81	$74.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.47 / $277.64 / $351.97	Professional		$100.47	$277.64	$351.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.20 / $82.11 / $108.60	Professional	26	$27.20	$82.11	$108.60
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $105.41 / $156.41 / $233.58	Professional		$105.41	$156.41	$233.58
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.61 / $42.68 / $79.27	Professional	26	$35.61	$42.68	$79.27
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $90.38 / $172.60 / $172.60	Facility	26	$90.38	$172.60	$172.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $109.27 / $169.94 / $810.58	Professional		$109.27	$169.94	$810.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $50.77 / $242.65	Professional	26	$26.30	$50.77	$242.65
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $72.81 / $74.94 / $211.98	Facility	26	$72.81	$74.94	$211.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $133.00 / $238.24 / $309.86	Professional		$133.00	$238.24	$309.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $38.35 / $111.55 / $197.15	Professional		$38.35	$111.55	$197.15
United Facility/Professional Professional Modifier Low / Median / High Price $107.63 / $135.94 / $227.94	Professional		$107.63	$135.94	$227.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.35 / $47.79 / $78.89	Professional	26	$29.35	$47.79	$78.89
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $162.35 / $205.50 / $241.80	Professional		$162.35	$205.50	$241.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $51.43 / $65.09 / $76.59	Professional	26	$51.43	$65.09	$76.59