Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $76.28 / $96.78 / $184.73	Facility	26	$76.28	$96.78	$184.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.56 / $133.91 / $612.00	Professional		$103.56	$133.91	$612.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $177.92 / $183.26 / $188.60	Facility	26	$177.92	$183.26	$188.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.38 / $265.29 / $331.61	Professional		$135.38	$265.29	$331.61
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $101.19 / $164.11 / $406.01	Professional		$101.19	$164.11	$406.01
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.82 / $79.17 / $213.77	Professional	26	$51.82	$79.17	$213.77
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $183.26 / $251.32 / $251.32	Facility	26	$183.26	$251.32	$251.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $119.30 / $188.37 / $759.56	Professional		$119.30	$188.37	$759.56
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $183.26 / $188.60 / $314.70	Facility	26	$183.26	$188.60	$314.70
Midlands Facility/Professional Professional Modifier Low / Median / High Price $206.33 / $242.28 / $384.93	Professional		$206.33	$242.28	$384.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $53.26 / $97.75 / $192.42	Professional		$53.26	$97.75	$192.42
United Facility/Professional Professional Modifier Low / Median / High Price $114.86 / $148.12 / $252.69	Professional		$114.86	$148.12	$252.69
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $159.26 / $201.60 / $237.20	Professional		$159.26	$201.60	$237.20