Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.33 / $170.18 / $313.01	Facility	26	$86.33	$170.18	$313.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $150.13 / $176.50 / $285.24	Professional		$150.13	$176.50	$285.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.42 / $83.60 / $158.83	Professional	26	$52.42	$83.60	$158.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $170.22 / $175.33 / $180.43	Facility	26	$170.22	$175.33	$180.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.16 / $392.50 / $541.08	Professional		$177.16	$392.50	$541.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.84 / $200.12 / $261.80	Professional	26	$66.84	$200.12	$261.80
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $153.61 / $279.32 / $851.88	Professional		$153.61	$279.32	$851.88
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $87.77 / $104.11 / $182.29	Professional	26	$87.77	$104.11	$182.29
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $221.69 / $423.87 / $423.87	Facility	26	$221.69	$423.87	$423.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $192.31 / $334.65 / $3,093.52	Professional		$192.31	$334.65	$3,093.52
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $63.18 / $120.40 / $676.01	Professional	26	$63.18	$120.40	$676.01
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $175.33 / $180.43 / $512.58	Facility	26	$175.33	$180.43	$512.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $287.47 / $364.34 / $803.00	Professional		$287.47	$364.34	$803.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $87.11 / $129.34 / $257.41	Professional		$87.11	$129.34	$257.41
United Facility/Professional Professional Modifier Low / Median / High Price $174.83 / $227.66 / $375.01	Professional		$174.83	$227.66	$375.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.54 / $114.95 / $191.58	Professional	26	$71.54	$114.95	$191.58
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $230.92 / $292.30 / $343.90	Professional		$230.92	$292.30	$343.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $126.32 / $159.90 / $188.10	Professional	26	$126.32	$159.90	$188.10