Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.25 / $47.25 / $141.82	Facility	26	$47.25	$47.25	$141.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.67 / $66.26 / $255.89	Professional		$59.67	$66.26	$255.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.82 / $89.42 / $92.03	Facility	26	$86.82	$89.42	$92.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.41 / $161.35 / $217.92	Professional		$87.41	$161.35	$217.92
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $62.03 / $120.34 / $425.98	Professional		$62.03	$120.34	$425.98
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.59 / $46.25 / $151.38	Professional	26	$25.59	$46.25	$151.38
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $89.42 / $171.77 / $171.77	Facility	26	$89.42	$171.77	$171.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $70.97 / $129.37 / $542.40	Professional		$70.97	$129.37	$542.40
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $89.42 / $92.03 / $154.80	Facility	26	$89.42	$92.03	$154.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $119.27 / $149.79 / $217.92	Professional		$119.27	$149.79	$217.92
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $27.36 / $50.75 / $115.97	Professional		$27.36	$50.75	$115.97
United Facility/Professional Professional Modifier Low / Median / High Price $70.97 / $89.65 / $174.22	Professional		$70.97	$89.65	$174.22
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $96.46 / $122.10 / $143.69	Professional		$96.46	$122.10	$143.69