Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $72.44 / $204.17	Facility	26	$57.54	$72.44	$204.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $89.13 / $309.03	Professional		$61.66	$89.13	$309.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $50.12 / $208.93	Professional	26	$38.02	$50.12	$208.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $162.18 / $204.17	Professional		$100.00	$162.18	$204.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $87.10 / $112.20	Professional	26	$60.26	$87.10	$112.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $107.15 / $302.00	Professional		$75.86	$107.15	$302.00
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $50.12 / $162.18	Professional	26	$39.81	$50.12	$162.18
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $186.21 / $186.21	Facility	26	$95.50	$186.21	$186.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $128.82 / $489.78	Professional		$74.13	$128.82	$489.78
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $70.79 / $263.03	Professional	26	$44.67	$70.79	$263.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $169.82 / $204.17	Professional		$128.82	$169.82	$204.17
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $102.33 / $112.20	Professional	26	$85.11	$102.33	$112.20
Midlands Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $199.53	Professional		$128.82	$128.82	$199.53
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $89.13 / $112.20	Professional	26	$89.13	$89.13	$112.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $74.13 / $151.36	Professional		$35.48	$74.13	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $100.00 / $194.98	Professional		$70.79	$100.00	$194.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $66.07 / $120.23	Professional	26	$43.65	$66.07	$120.23
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $151.36 / $177.83	Professional		$120.23	$151.36	$177.83
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $81.28 / $95.50	Professional	26	$64.57	$81.28	$95.50