Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $61.66 / $61.66	Facility	26	$61.66	$61.66	$61.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $66.07 / $89.13	Professional		$52.48	$66.07	$89.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $45.71 / $61.66	Professional	26	$38.02	$45.71	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $144.54 / $173.78	Professional		$117.49	$144.54	$173.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $102.33 / $120.23	Professional	26	$79.43	$102.33	$120.23
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $97.72 / $269.15	Professional		$66.07	$97.72	$269.15
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $63.10 / $181.97	Professional	26	$45.71	$63.10	$181.97
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $199.53 / $199.53 / $199.53	Facility	26	$199.53	$199.53	$199.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $138.04 / $407.38	Professional		$74.13	$138.04	$407.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $91.20 / $281.84	Professional	26	$51.29	$91.20	$281.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $158.49 / $169.82	Professional		$112.20	$158.49	$169.82
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $112.20 / $117.49	Professional	26	$79.43	$112.20	$117.49
Midlands Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $245.47	Professional		$169.82	$169.82	$245.47
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $120.23 / $177.83	Professional	26	$117.49	$120.23	$177.83
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $58.88 / $123.03	Professional		$19.95	$58.88	$123.03
United Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $114.82 / $169.82	Professional		$67.61	$114.82	$169.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $77.62 / $125.89	Professional	26	$48.98	$77.62	$125.89
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $128.82	Professional		$109.65	$109.65	$128.82
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $75.86 / $89.13	Professional	26	$75.86	$75.86	$89.13