Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $240.93 / $240.93 / $240.93	Facility	26	$240.93	$240.93	$240.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $145.30 / $203.54 / $848.49	Professional		$145.30	$203.54	$848.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $249.81 / $358.33 / $430.08	Professional		$249.81	$358.33	$430.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $147.18 / $227.60 / $511.74	Professional		$147.18	$227.60	$511.74
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $83.99 / $131.08 / $277.91	Professional	26	$83.99	$131.08	$277.91
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $212.19 / $420.63 / $420.63	Facility	26	$212.19	$420.63	$420.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $167.28 / $322.89 / $1,321.58	Professional		$167.28	$322.89	$1,321.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $236.25 / $320.29 / $403.57	Professional		$236.25	$320.29	$403.57
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $75.09 / $149.44 / $291.10	Professional		$75.09	$149.44	$291.10
United Facility/Professional Professional Modifier Low / Median / High Price $159.66 / $234.12 / $430.68	Professional		$159.66	$234.12	$430.68
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $259.36 / $328.30 / $386.20	Professional		$259.36	$328.30	$386.20