Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $171.87 / $171.87 / $171.87	Facility	26	$171.87	$171.87	$171.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.90 / $152.83 / $473.00	Professional		$104.90	$152.83	$473.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.02 / $85.17 / $336.30	Professional	26	$60.02	$85.17	$336.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $196.12 / $253.73 / $361.94	Professional		$196.12	$253.73	$361.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.32 / $144.80 / $209.94	Professional	26	$111.32	$144.80	$209.94
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $98.65 / $150.94 / $312.32	Professional		$98.65	$150.94	$312.32
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $59.77 / $88.95 / $216.36	Professional	26	$59.77	$88.95	$216.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $155.19 / $261.00 / $728.40	Professional		$155.19	$261.00	$728.40
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $85.41 / $150.69 / $414.32	Professional	26	$85.41	$150.69	$414.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $185.98 / $248.22 / $319.64	Professional		$185.98	$248.22	$319.64
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $47.38 / $102.71 / $198.19	Professional		$47.38	$102.71	$198.19
United Facility/Professional Professional Modifier Low / Median / High Price $133.11 / $228.75 / $347.25	Professional		$133.11	$228.75	$347.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $76.09 / $123.08 / $179.98	Professional	26	$76.09	$123.08	$179.98
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $173.96 / $220.20 / $259.10	Professional		$173.96	$220.20	$259.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $101.75 / $128.80 / $151.50	Professional	26	$101.75	$128.80	$151.50