Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $19.95 / $125.89	Facility	26	$19.95	$19.95	$125.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $123.03 / $213.80	Professional		$100.00	$123.03	$213.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $21.88 / $69.18	Professional	26	$18.20	$21.88	$69.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $74.13 / $77.62	Facility	26	$72.44	$74.13	$77.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $316.23 / $398.11	Professional		$144.54	$316.23	$398.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $53.70 / $66.07	Professional	26	$28.84	$53.70	$66.07
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $173.78 / $316.23	Professional		$117.49	$173.78	$316.23
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $36.31 / $60.26	Professional	26	$21.38	$36.31	$60.26
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $109.65 / $109.65	Facility	26	$74.13	$109.65	$109.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $199.53 / $891.25	Professional		$109.65	$199.53	$891.25
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $34.67 / $186.21	Professional	26	$24.55	$34.67	$186.21
Midlands Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $263.03 / $338.84	Professional		$199.53	$263.03	$338.84
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $52.48 / $63.10	Professional	26	$46.77	$52.48	$63.10
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $77.62 / $77.62	Facility	26	$77.62	$77.62	$77.62
Midlands Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $229.09 / $338.84	Professional		$213.80	$229.09	$338.84
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $53.70 / $72.44	Professional	26	$46.77	$53.70	$72.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $120.23 / $239.88	Professional		$23.99	$120.23	$239.88
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $144.54 / $275.42	Professional		$109.65	$144.54	$275.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $29.51 / $54.95	Professional	26	$23.99	$29.51	$54.95
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $269.15	Professional		$229.09	$229.09	$269.15
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $38.90 / $45.71	Professional	26	$38.90	$38.90	$45.71