Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.45 / $82.97 / $168.77	Facility	26	$44.45	$82.97	$168.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.43 / $113.48 / $181.31	Professional		$95.43	$113.48	$181.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.40 / $43.67 / $78.22	Professional	26	$32.40	$43.67	$78.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.05 / $108.20 / $111.35	Facility	26	$105.05	$108.20	$111.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.03 / $245.90 / $323.20	Professional		$108.03	$245.90	$323.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.00 / $108.60 / $135.75	Professional	26	$40.00	$108.60	$135.75
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $94.48 / $139.44 / $261.20	Professional		$94.48	$139.44	$261.20
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.11 / $64.17 / $94.22	Professional	26	$45.11	$64.17	$94.22
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $114.26 / $217.99 / $217.99	Facility	26	$114.26	$217.99	$217.99
Medica Facility/Professional Professional Modifier Low / Median / High Price $104.22 / $165.00 / $803.00	Professional		$104.22	$165.00	$803.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $34.76 / $43.73 / $310.62	Professional	26	$34.76	$43.73	$310.62
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $108.20 / $111.35 / $268.74	Facility	26	$108.20	$111.35	$268.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $140.40 / $226.29 / $314.19	Professional		$140.40	$226.29	$314.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $51.24 / $91.46 / $177.52	Professional		$51.24	$91.46	$177.52
United Facility/Professional Professional Modifier Low / Median / High Price $100.64 / $130.32 / $205.22	Professional		$100.64	$130.32	$205.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.60 / $40.79 / $70.69	Professional	26	$33.60	$40.79	$70.69
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $143.46 / $181.60 / $213.60	Professional		$143.46	$181.60	$213.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $64.94 / $82.20 / $96.70	Professional	26	$64.94	$82.20	$96.70