Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.00 / $39.00 / $115.73	Facility	26	$39.00	$39.00	$115.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.43 / $78.02 / $108.66	Professional		$71.43	$78.02	$108.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.58 / $72.70 / $74.81	Facility	26	$70.58	$72.70	$74.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.47 / $189.27 / $261.11	Professional		$88.47	$189.27	$261.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $70.84 / $105.89 / $209.55	Professional		$70.84	$105.89	$209.55
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.20 / $34.50 / $61.20	Professional	26	$21.20	$34.50	$61.20
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $72.70 / $102.96 / $102.96	Facility	26	$72.70	$102.96	$102.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $83.71 / $129.85 / $758.00	Professional		$83.71	$129.85	$758.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $72.70 / $74.81 / $124.74	Facility	26	$72.70	$74.81	$124.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $110.00 / $175.00 / $237.69	Professional		$110.00	$175.00	$237.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $23.55 / $72.50 / $143.12	Professional		$23.55	$72.50	$143.12
United Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $110.69 / $184.76	Professional		$85.00	$110.69	$184.76
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $109.57 / $138.69 / $163.19	Professional		$109.57	$138.69	$163.19