Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.01 / $5.01 / $5.01	Facility	26	$5.01	$5.01	$5.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $53.70 / $223.87	Professional		$40.74	$53.70	$223.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $104.71 / $131.83	Professional		$51.29	$104.71	$131.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $87.10 / $218.78	Professional		$42.66	$87.10	$218.78
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $3.39 / $5.50 / $15.85	Professional	26	$3.39	$5.50	$15.85
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $100.00 / $100.00	Facility	26	$8.51	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $97.72 / $446.68	Professional		$53.70	$97.72	$446.68
Midlands Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $112.20 / $125.89	Professional		$97.72	$112.20	$125.89
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $8.91 / $11.22	Professional	26	$7.41	$8.91	$11.22
Midlands Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $97.72 / $213.80	Professional		$95.50	$97.72	$213.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $4.17 / $50.12 / $107.15	Professional		$4.17	$50.12	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $74.13 / $125.89	Professional		$51.29	$74.13	$125.89
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $91.20 / $107.15	Professional		$72.44	$91.20	$107.15