Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.88 / $177.49 / $177.49	Facility	26	$61.88	$177.49	$177.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.88 / $180.68 / $394.07	Professional		$128.88	$180.68	$394.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.07 / $72.18 / $296.00	Professional	26	$62.07	$72.18	$296.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.88 / $325.22 / $406.53	Professional		$151.88	$325.22	$406.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.31 / $136.09 / $170.86	Professional	26	$71.31	$136.09	$170.86
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $142.79 / $214.77 / $703.44	Professional		$142.79	$214.77	$703.44
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.97 / $102.03 / $442.90	Professional	26	$64.97	$102.03	$442.90
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $157.36 / $302.75 / $302.75	Facility	26	$157.36	$302.75	$302.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $165.17 / $307.69 / $982.06	Professional		$165.17	$307.69	$982.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $78.79 / $130.59 / $428.85	Professional	26	$78.79	$130.59	$428.85
Midlands Facility/Professional Professional Modifier Low / Median / High Price $191.34 / $320.52 / $402.68	Professional		$191.34	$320.52	$402.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $70.20 / $140.88 / $280.64	Professional		$70.20	$140.88	$280.64
United Facility/Professional Professional Modifier Low / Median / High Price $165.17 / $253.77 / $403.66	Professional		$165.17	$253.77	$403.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.37 / $109.62 / $181.32	Professional	26	$75.37	$109.62	$181.32
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $232.10 / $293.80 / $345.60	Professional		$232.10	$293.80	$345.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $99.62 / $126.10 / $148.30	Professional	26	$99.62	$126.10	$148.30