Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.83 / $63.83 / $107.14	Facility	26	$63.83	$63.83	$107.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.43 / $91.41 / $163.65	Professional		$78.43	$91.41	$163.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.88 / $110.09 / $113.29	Facility	26	$106.88	$110.09	$113.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.34 / $220.30 / $290.45	Professional		$94.34	$220.30	$290.45
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $85.65 / $142.72 / $358.97	Professional		$85.65	$142.72	$358.97
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.13 / $55.45 / $115.49	Professional	26	$35.13	$55.45	$115.49
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $110.09 / $169.56 / $169.56	Facility	26	$110.09	$169.56	$169.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $100.33 / $171.86 / $767.00	Professional		$100.33	$171.86	$767.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $110.09 / $113.29 / $208.08	Facility	26	$110.09	$113.29	$208.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $172.89 / $206.91 / $285.02	Professional		$172.89	$206.91	$285.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $148.60 / $220.20 / $261.00	Professional		$148.60	$220.20	$261.00
United Facility/Professional Professional Modifier Low / Median / High Price $92.70 / $114.24 / $210.90	Professional		$92.70	$114.24	$210.90
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $127.66 / $161.60 / $190.10	Professional		$127.66	$161.60	$190.10