Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.64 / $202.38 / $374.58	Facility	26	$101.64	$202.38	$374.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.08 / $118.55 / $221.76	Professional		$83.08	$118.55	$221.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.99 / $70.20 / $336.22	Professional	26	$59.99	$70.20	$336.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $201.71 / $207.76 / $213.81	Facility	26	$201.71	$207.76	$213.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $203.52 / $236.60 / $277.31	Professional		$203.52	$236.60	$277.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $143.75 / $166.59 / $202.39	Professional	26	$143.75	$166.59	$202.39
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $86.52 / $160.97 / $545.64	Professional		$86.52	$160.97	$545.64
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $62.68 / $116.74 / $181.57	Professional	26	$62.68	$116.74	$181.57
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $207.76 / $305.79 / $305.79	Facility	26	$207.76	$305.79	$305.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $103.35 / $203.52 / $1,748.00	Professional		$103.35	$203.52	$1,748.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $69.61 / $109.55 / $496.08	Professional	26	$69.61	$109.55	$496.08
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $207.76 / $213.81 / $376.14	Facility	26	$207.76	$213.81	$376.14
Midlands Facility/Professional Professional Modifier Low / Median / High Price $176.90 / $203.52 / $422.00	Professional		$176.90	$203.52	$422.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $160.40 / $193.30 / $503.00	Professional		$160.40	$193.30	$503.00
United Facility/Professional Professional Modifier Low / Median / High Price $98.86 / $128.13 / $226.32	Professional		$98.86	$128.13	$226.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.15 / $86.99 / $161.83	Professional	26	$69.15	$86.99	$161.83
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $169.60 / $169.60 / $199.50	Professional		$169.60	$169.60	$199.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $119.80 / $119.80 / $140.90	Professional	26	$119.80	$119.80	$140.90