Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.43 / $79.43 / $416.87	Facility	26	$79.43	$79.43	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $426.58 / $891.25	Professional		$275.42	$426.58	$891.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $245.47 / $251.19 / $257.04	Facility	26	$245.47	$251.19	$257.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $676.08 / $912.01	Professional		$436.52	$676.08	$912.01
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $467.74 / $1,949.84	Professional		$245.47	$467.74	$1,949.84
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $128.82 / $489.78	Professional	26	$70.79	$128.82	$489.78
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $562.34 / $724.44 / $724.44	Facility	26	$562.34	$724.44	$724.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $660.69 / $3,311.31	Professional		$346.74	$660.69	$3,311.31
Midlands Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $851.14 / $1,096.48	Professional		$537.03	$851.14	$1,096.48
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $177.83 / $239.88	Professional	26	$154.88	$177.83	$239.88
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $257.04 / $257.04 / $257.04	Facility	26	$257.04	$257.04	$257.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $660.69 / $1,096.48	Professional		$630.96	$660.69	$1,096.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $199.53 / $446.68	Professional		$77.62	$199.53	$446.68
United Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $501.19 / $954.99	Professional		$309.03	$501.19	$954.99
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $602.56 / $707.95	Professional		$602.56	$602.56	$707.95