Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.78 / $42.10 / $129.05	Facility	26	$22.78	$42.10	$129.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.67 / $56.19 / $92.51	Professional		$51.67	$56.19	$92.51
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.64 / $82.03 / $84.42	Facility	26	$79.64	$82.03	$84.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.49 / $138.85 / $175.38	Professional		$61.49	$138.85	$175.38
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $53.27 / $91.34 / $181.57	Professional		$53.27	$91.34	$181.57
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.19 / $37.59 / $80.53	Professional	26	$23.19	$37.59	$80.53
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $82.03 / $113.82 / $113.82	Facility	26	$82.03	$113.82	$113.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $61.36 / $103.00 / $388.28	Professional		$61.36	$103.00	$388.28
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $82.03 / $84.42 / $135.47	Facility	26	$82.03	$84.42	$135.47
Midlands Facility/Professional Professional Modifier Low / Median / High Price $106.79 / $123.84 / $203.77	Professional		$106.79	$123.84	$203.77
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $25.03 / $53.94 / $100.50	Professional		$25.03	$53.94	$100.50
United Facility/Professional Professional Modifier Low / Median / High Price $55.78 / $66.94 / $112.85	Professional		$55.78	$66.94	$112.85
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $81.20 / $102.80 / $120.90	Professional		$81.20	$102.80	$120.90