Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.18 / $87.96 / $176.24	Facility	26	$58.18	$87.96	$176.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.97 / $96.48 / $353.63	Professional		$63.97	$96.48	$353.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.58 / $42.47 / $197.61	Professional	26	$33.58	$42.47	$197.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.19 / $146.16 / $188.56	Professional		$106.19	$146.16	$188.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.35 / $76.08 / $96.54	Professional	26	$53.35	$76.08	$96.54
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $69.38 / $92.68 / $275.79	Professional		$69.38	$92.68	$275.79
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.08 / $44.64 / $135.30	Professional	26	$36.08	$44.64	$135.30
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $83.11 / $158.93 / $158.93	Facility	26	$83.11	$158.93	$158.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $67.48 / $120.93 / $457.11	Professional		$67.48	$120.93	$457.11
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $38.67 / $66.27 / $229.85	Professional	26	$38.67	$66.27	$229.85
Midlands Facility/Professional Professional Modifier Low / Median / High Price $89.89 / $131.55 / $183.95	Professional		$89.89	$131.55	$183.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $32.02 / $62.60 / $122.80	Professional		$32.02	$62.60	$122.80
United Facility/Professional Professional Modifier Low / Median / High Price $65.06 / $91.70 / $178.90	Professional		$65.06	$91.70	$178.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.67 / $59.52 / $106.81	Professional	26	$38.67	$59.52	$106.81
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $138.80 / $163.30	Professional		$109.65	$138.80	$163.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $55.38 / $70.09 / $82.40	Professional	26	$55.38	$70.09	$82.40