Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.65 / $39.65 / $119.35	Facility	26	$39.65	$39.65	$119.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.56 / $118.09 / $173.95	Professional		$101.56	$118.09	$173.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.78 / $22.23 / $30.81	Professional	26	$19.78	$22.23	$30.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.41 / $74.58 / $76.75	Facility	26	$72.41	$74.58	$76.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.60 / $312.61 / $390.76	Professional		$108.60	$312.61	$390.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.15 / $51.97 / $64.95	Professional	26	$24.15	$51.97	$64.95
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $114.62 / $171.46 / $251.17	Professional		$114.62	$171.46	$251.17
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.26 / $34.34 / $57.00	Professional	26	$21.26	$34.34	$57.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $74.58 / $110.00 / $110.00	Facility	26	$74.58	$110.00	$110.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $115.45 / $182.22 / $893.01	Professional		$115.45	$182.22	$893.01
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $24.28 / $31.10 / $188.00	Professional	26	$24.28	$31.10	$188.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $74.58 / $76.75 / $128.69	Facility	26	$74.58	$76.75	$128.69
Midlands Facility/Professional Professional Modifier Low / Median / High Price $161.00 / $262.02 / $342.29	Professional		$161.00	$262.02	$342.29
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $23.75 / $126.14 / $216.38	Professional		$23.75	$126.14	$216.38
United Facility/Professional Professional Modifier Low / Median / High Price $113.34 / $147.51 / $255.17	Professional		$113.34	$147.51	$255.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.88 / $29.85 / $50.40	Professional	26	$23.88	$29.85	$50.40
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $179.09 / $226.70 / $266.70	Professional		$179.09	$226.70	$266.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $30.65 / $38.79 / $45.70	Professional	26	$30.65	$38.79	$45.70