Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $155.55 / $155.55 / $426.32	Facility	26	$155.55	$155.55	$426.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.07 / $160.40 / $275.14	Professional		$137.07	$160.40	$275.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.76 / $84.39 / $155.55	Professional	26	$77.76	$84.39	$155.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $263.33 / $271.24 / $279.14	Facility	26	$263.33	$271.24	$279.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $184.67 / $366.14 / $553.88	Professional		$184.67	$366.14	$553.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.10 / $204.01 / $283.74	Professional	26	$99.10	$204.01	$283.74
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $140.99 / $254.21 / $943.23	Professional		$140.99	$254.21	$943.23
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $86.78 / $135.88 / $245.65	Professional	26	$86.78	$135.88	$245.65
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $271.24 / $419.33 / $419.33	Facility	26	$271.24	$419.33	$419.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $176.74 / $312.70 / $3,391.09	Professional		$176.74	$312.70	$3,391.09
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $94.07 / $122.50 / $632.75	Professional	26	$94.07	$122.50	$632.75
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $271.24 / $279.14 / $504.54	Facility	26	$271.24	$279.14	$504.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $292.39 / $365.46 / $888.00	Professional		$292.39	$365.46	$888.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $203.30 / $203.30 / $606.70	Professional		$203.30	$203.30	$606.70
United Facility/Professional Professional Modifier Low / Median / High Price $160.66 / $209.22 / $391.99	Professional		$160.66	$209.22	$391.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $94.07 / $112.88 / $188.14	Professional	26	$94.07	$112.88	$188.14
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $211.09 / $267.20 / $314.39	Professional		$211.09	$267.20	$314.39
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $124.98 / $158.19 / $186.10	Professional	26	$124.98	$158.19	$186.10