Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.91 / $30.91 / $93.56	Facility	26	$30.91	$30.91	$93.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.84 / $86.46 / $379.32	Professional		$71.84	$86.46	$379.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.87 / $58.58 / $60.28	Facility	26	$56.87	$58.58	$60.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.95 / $212.54 / $265.68	Professional		$80.95	$212.54	$265.68
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $78.42 / $117.57 / $203.56	Professional		$78.42	$117.57	$203.56
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.85 / $27.48 / $50.38	Professional	26	$16.85	$27.48	$50.38
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $58.58 / $100.00 / $100.00	Facility	26	$58.58	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $83.89 / $135.66 / $635.08	Professional		$83.89	$135.66	$635.08
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $58.58 / $60.28 / $101.10	Facility	26	$58.58	$60.28	$101.10
Midlands Facility/Professional Professional Modifier Low / Median / High Price $124.00 / $182.18 / $245.04	Professional		$124.00	$182.18	$245.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $16.89 / $60.53 / $145.44	Professional		$16.89	$60.53	$145.44
United Facility/Professional Professional Modifier Low / Median / High Price $79.70 / $100.67 / $168.79	Professional		$79.70	$100.67	$168.79
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $122.21 / $154.69 / $182.00	Professional		$122.21	$154.69	$182.00