Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.18 / $35.48 / $100.00	Facility	26	$28.18	$35.48	$100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $52.48 / $275.42	Professional		$30.90	$52.48	$275.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $22.91 / $51.29	Professional	26	$18.20	$22.91	$51.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $109.65 / $134.90	Professional		$66.07	$109.65	$134.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $42.66 / $54.95	Professional	26	$30.90	$42.66	$54.95
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $67.61 / $147.91	Professional		$45.71	$67.61	$147.91
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $25.12 / $58.88	Professional	26	$19.05	$25.12	$58.88
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $97.72 / $97.72	Facility	26	$47.86	$97.72	$97.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $74.13 / $331.13	Professional		$42.66	$74.13	$331.13
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $39.81 / $128.82	Professional	26	$22.91	$39.81	$128.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $89.13 / $134.90	Professional		$74.13	$89.13	$134.90
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $51.29 / $60.26	Professional	26	$38.02	$51.29	$60.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $131.83	Professional		$64.57	$64.57	$131.83
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $43.65 / $54.95	Professional	26	$43.65	$43.65	$54.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $48.98 / $102.33	Professional		$21.38	$48.98	$102.33
United Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $67.61 / $114.82	Professional		$42.66	$67.61	$114.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $37.15 / $60.26	Professional	26	$22.91	$37.15	$60.26
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $100.00 / $117.49	Professional		$79.43	$100.00	$117.49
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $40.74 / $47.86	Professional	26	$32.36	$40.74	$47.86