Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $11.45 / $18.46 / $209.00	Facility		$11.45	$18.46	$209.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.46 / $56.71 / $197.52	Facility	26	$18.46	$56.71	$197.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.57 / $56.26 / $59.14	Professional		$47.57	$56.26	$59.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.20 / $55.89 / $139.85	Professional	26	$19.20	$55.89	$139.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.38 / $67.97 / $87.19	Professional		$54.38	$67.97	$87.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.00 / $63.75 / $81.69	Professional	26	$51.00	$63.75	$81.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $45.14 / $72.70 / $141.33	Professional		$45.14	$72.70	$141.33
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.97 / $57.73 / $141.33	Professional	26	$37.97	$57.73	$141.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $18.46 / $59.14 / $117.91	Facility		$18.46	$59.14	$117.91
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $223.26 / $223.26 / $223.26	Facility	26	$223.26	$223.26	$223.26
Medica Facility/Professional Professional Modifier Low / Median / High Price $20.99 / $36.19 / $126.11	Professional		$20.99	$36.19	$126.11
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $20.98 / $31.30 / $117.10	Professional	26	$20.98	$31.30	$117.10
Midlands Facility/Professional Facility Modifier Low / Median / High Price $22.46 / $64.38 / $115.65	Facility		$22.46	$64.38	$115.65
Midlands Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $38.15 / $115.65	Professional		$22.91	$38.15	$115.65
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.45 / $45.77 / $84.63	Professional		$3.45	$45.77	$84.63
United Facility/Professional Professional Modifier Low / Median / High Price $20.07 / $29.20 / $49.64	Professional		$20.07	$29.20	$49.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.07 / $29.18 / $49.61	Professional	26	$20.07	$29.18	$49.61
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $82.80 / $97.50 / $112.40	Professional		$82.80	$97.50	$112.40
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $77.20 / $90.80 / $104.70	Professional	26	$77.20	$90.80	$104.70