Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.95 / $82.34 / $152.16	Facility	26	$40.95	$82.34	$152.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.90 / $97.41 / $191.80	Professional		$88.90	$97.41	$191.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.05 / $81.42 / $83.79	Facility	26	$79.05	$81.42	$83.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.75 / $246.67 / $387.29	Professional		$129.75	$246.67	$387.29
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $91.86 / $170.07 / $799.98	Professional		$91.86	$170.07	$799.98
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.47 / $38.08 / $64.50	Professional	26	$23.47	$38.08	$64.50
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $81.42 / $277.13 / $277.13	Facility	26	$81.42	$277.13	$277.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $117.87 / $215.59 / $2,945.80	Professional		$117.87	$215.59	$2,945.80
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $81.42 / $83.79 / $137.88	Facility	26	$81.42	$83.79	$137.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $246.29 / $755.00	Professional		$194.98	$246.29	$755.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $141.19 / $141.19 / $432.40	Professional		$141.19	$141.19	$432.40
United Facility/Professional Professional Modifier Low / Median / High Price $110.10 / $140.75 / $267.88	Professional		$110.10	$140.75	$267.88
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $142.52 / $180.40 / $212.30	Professional		$142.52	$180.40	$212.30