Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2.57 / $18.62 / $223.87	Facility		$2.57	$18.62	$223.87
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $54.95 / $208.93	Facility	26	$18.62	$54.95	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $46.77 / $58.88	Professional		$15.85	$46.77	$58.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $51.29 / $138.04	Professional	26	$19.95	$51.29	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $67.61 / $70.79	Professional		$54.95	$67.61	$70.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $60.26 / $66.07	Professional	26	$51.29	$60.26	$66.07
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $79.43 / $141.25	Professional		$44.67	$79.43	$141.25
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $64.57 / $141.25	Professional	26	$38.02	$64.57	$141.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $18.62 / $61.66 / $125.89	Facility		$18.62	$61.66	$125.89
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $223.87 / $223.87 / $223.87	Facility	26	$223.87	$223.87	$223.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $38.02 / $128.82	Professional		$20.89	$38.02	$128.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $33.88 / $281.84	Professional	26	$21.88	$33.88	$281.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $87.10 / $125.89	Professional		$64.57	$87.10	$125.89
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $66.07 / $120.23	Professional	26	$30.20	$66.07	$120.23
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $29.51 / $29.51	Professional	26	$29.51	$29.51	$29.51
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.39 / $46.77 / $97.72	Professional		$3.39	$46.77	$97.72
United Facility/Professional Facility Modifier Low / Median / High Price $2.95 / $2.95 / $4.68	Facility		$2.95	$2.95	$4.68
United Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $29.51 / $53.70	Professional		$19.95	$29.51	$53.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $29.51 / $53.70	Professional	26	$19.95	$29.51	$53.70
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $97.72 / $112.20	Professional		$83.18	$97.72	$112.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $91.20 / $104.71	Professional	26	$77.62	$91.20	$104.71