Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.10 / $32.10 / $32.10	Facility	26	$32.10	$32.10	$32.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.95 / $57.74 / $78.58	Professional		$50.95	$57.74	$78.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.13 / $73.26 / $75.40	Facility	26	$71.13	$73.26	$75.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.47 / $138.85 / $173.56	Professional		$62.47	$138.85	$173.56
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $58.80 / $86.45 / $328.06	Professional		$58.80	$86.45	$328.06
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.54 / $33.68 / $140.46	Professional	26	$23.54	$33.68	$140.46
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $73.26 / $104.46 / $104.46	Facility	26	$73.26	$104.46	$104.46
Medica Facility/Professional Professional Modifier Low / Median / High Price $56.98 / $78.39 / $355.61	Professional		$56.98	$78.39	$355.61
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $73.26 / $75.40 / $137.88	Facility	26	$73.26	$75.40	$137.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $115.57 / $131.66 / $219.29	Professional		$115.57	$131.66	$219.29
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $78.80 / $78.80 / $78.80	Professional		$78.80	$78.80	$78.80
United Facility/Professional Professional Modifier Low / Median / High Price $56.98 / $69.55 / $128.66	Professional		$56.98	$69.55	$128.66
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $83.35 / $105.50 / $124.20	Professional		$83.35	$105.50	$124.20