Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.78 / $37.78 / $37.78	Facility	26	$37.78	$37.78	$37.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.40 / $87.59 / $120.15	Professional		$80.40	$87.59	$120.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.00 / $86.52 / $89.04	Facility	26	$84.00	$86.52	$89.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.29 / $216.42 / $270.52	Professional		$101.29	$216.42	$270.52
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $91.16 / $134.33 / $519.44	Professional		$91.16	$134.33	$519.44
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.63 / $41.27 / $159.62	Professional	26	$28.63	$41.27	$159.62
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $86.52 / $127.16 / $127.16	Facility	26	$86.52	$127.16	$127.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $91.70 / $125.99 / $579.19	Professional		$91.70	$125.99	$579.19
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $86.52 / $89.04 / $157.32	Facility	26	$86.52	$89.04	$157.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $174.83 / $201.38 / $354.15	Professional		$174.83	$201.38	$354.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $123.30 / $123.30 / $123.30	Professional		$123.30	$123.30	$123.30
United Facility/Professional Professional Modifier Low / Median / High Price $89.99 / $107.99 / $226.62	Professional		$89.99	$107.99	$226.62
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $129.72 / $164.20 / $193.20	Professional		$129.72	$164.20	$193.20