Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.97 / $54.11 / $99.67	Facility	26	$34.97	$54.11	$99.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.52 / $130.26 / $198.12	Professional		$111.52	$130.26	$198.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.40 / $55.00 / $56.60	Facility	26	$53.40	$55.00	$56.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.80 / $284.66 / $392.70	Professional		$86.80	$284.66	$392.70
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $104.31 / $130.87 / $307.68	Professional		$104.31	$130.87	$307.68
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.49 / $32.04 / $59.14	Professional	26	$22.49	$32.04	$59.14
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $56.90 / $109.00 / $109.00	Facility	26	$56.90	$109.00	$109.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $102.84 / $181.49 / $899.44	Professional		$102.84	$181.49	$899.44
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $55.00 / $56.60 / $132.00	Facility	26	$55.00	$56.60	$132.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $123.00 / $241.16 / $343.48	Professional		$123.00	$241.16	$343.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $24.53 / $123.28 / $222.43	Professional		$24.53	$123.28	$222.43
United Facility/Professional Professional Modifier Low / Median / High Price $94.45 / $154.28 / $256.26	Professional		$94.45	$154.28	$256.26
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $180.44 / $228.40 / $268.70	Professional		$180.44	$228.40	$268.70