Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $99.12 / $99.12 / $278.92	Facility	26	$99.12	$99.12	$278.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.87 / $145.40 / $685.00	Professional		$119.87	$145.40	$685.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $163.53 / $168.44 / $173.34	Facility	26	$163.53	$168.44	$173.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.70 / $367.91 / $519.72	Professional		$126.70	$367.91	$519.72
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $216.37 / $433.96	Professional		$150.00	$216.37	$433.96
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.07 / $92.79 / $171.00	Professional	26	$58.07	$92.79	$171.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $168.44 / $284.58 / $284.58	Facility	26	$168.44	$284.58	$284.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $126.91 / $204.39 / $936.67	Professional		$126.91	$204.39	$936.67
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $168.44 / $173.34 / $327.06	Facility	26	$168.44	$173.34	$327.06
Midlands Facility/Professional Professional Modifier Low / Median / High Price $189.56 / $313.54 / $398.73	Professional		$189.56	$313.54	$398.73
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $67.05 / $133.46 / $309.11	Professional		$67.05	$133.46	$309.11
United Facility/Professional Professional Modifier Low / Median / High Price $126.91 / $160.31 / $292.70	Professional		$126.91	$160.31	$292.70
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $253.83 / $321.30 / $378.00	Professional		$253.83	$321.30	$378.00