Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.22 / $104.33 / $116.32	Professional		$89.22	$104.33	$116.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.11 / $44.83 / $49.99	Professional	26	$39.11	$44.83	$49.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.39 / $269.12 / $391.56	Professional		$119.39	$269.12	$391.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.37 / $109.95 / $160.31	Professional	26	$61.37	$109.95	$160.31
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $107.19 / $171.15 / $274.77	Professional		$107.19	$171.15	$274.77
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.36 / $84.68 / $139.38	Professional	26	$43.36	$84.68	$139.38
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $317.04 / $317.04 / $317.04	Facility	26	$317.04	$317.04	$317.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $128.16 / $232.52 / $1,000.49	Professional		$128.16	$232.52	$1,000.49
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $55.85 / $71.53 / $415.79	Professional	26	$55.85	$71.53	$415.79
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $199.60 / $199.60 / $199.60	Facility	26	$199.60	$199.60	$199.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $146.80 / $235.44 / $364.66	Professional		$146.80	$235.44	$364.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $49.31 / $111.99 / $212.42	Professional		$49.31	$111.99	$212.42
United Facility/Professional Professional Modifier Low / Median / High Price $128.15 / $132.02 / $310.86	Professional		$128.15	$132.02	$310.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.78 / $57.53 / $135.46	Professional	26	$55.78	$57.53	$135.46
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $214.50 / $252.30 / $296.70	Professional		$214.50	$252.30	$296.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $87.40 / $102.80 / $120.90	Professional	26	$87.40	$102.80	$120.90