Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.18 / $54.18 / $54.18	Facility	26	$54.18	$54.18	$54.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.70 / $135.22 / $150.78	Professional		$114.70	$135.22	$150.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.52 / $32.79 / $36.57	Professional	26	$28.52	$32.79	$36.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.02 / $201.13 / $361.77	Professional		$67.02	$201.13	$361.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.61 / $69.00 / $104.69	Professional	26	$31.61	$69.00	$104.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $76.45 / $179.01 / $253.21	Professional		$76.45	$179.01	$253.21
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.78 / $60.38 / $108.37	Professional	26	$37.78	$60.38	$108.37
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $166.51 / $166.51 / $166.51	Facility	26	$166.51	$166.51	$166.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $123.17 / $210.59 / $1,357.00	Professional		$123.17	$210.59	$1,357.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $37.04 / $60.63 / $271.00	Professional	26	$37.04	$60.63	$271.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $91.61 / $91.61 / $91.61	Facility	26	$91.61	$91.61	$91.61
Midlands Facility/Professional Professional Modifier Low / Median / High Price $150.07 / $230.54 / $326.87	Professional		$150.07	$230.54	$326.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $35.77 / $141.25 / $266.38	Professional		$35.77	$141.25	$266.38
United Facility/Professional Professional Modifier Low / Median / High Price $129.22 / $133.10 / $302.50	Professional		$129.22	$133.10	$302.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.04 / $39.07 / $91.46	Professional	26	$37.04	$39.07	$91.46
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $272.89 / $321.10 / $377.60	Professional		$272.89	$321.10	$377.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $62.40 / $73.40 / $86.40	Professional	26	$62.40	$73.40	$86.40