Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $12.88 / $12.88	Facility	26	$12.88	$12.88	$12.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $54.95 / $151.36	Professional		$42.66	$54.95	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $104.71 / $138.04	Professional		$53.70	$104.71	$138.04
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $112.20 / $302.00	Professional		$44.67	$112.20	$302.00
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $14.45 / $52.48	Professional	26	$9.12	$14.45	$52.48
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $169.82 / $169.82	Facility	26	$25.12	$169.82	$169.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $107.15 / $616.60	Professional		$56.23	$107.15	$616.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $117.49 / $144.54	Professional		$102.33	$117.49	$144.54
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $23.44 / $29.51	Professional	26	$19.95	$23.44	$29.51
Midlands Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $104.71 / $213.80	Professional		$100.00	$104.71	$213.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $46.77 / $100.00	Professional		$10.23	$46.77	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $83.18 / $138.04	Professional		$53.70	$83.18	$138.04
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $91.20 / $107.15	Professional		$72.44	$91.20	$107.15