Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.17 / $193.07 / $357.00	Facility	26	$123.17	$193.07	$357.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $197.54 / $236.22 / $405.50	Professional		$197.54	$236.22	$405.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $59.99 / $100.26	Professional	26	$55.00	$59.99	$100.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $188.15 / $193.79 / $199.44	Facility	26	$188.15	$193.79	$199.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $293.70 / $478.37 / $881.37	Professional		$293.70	$478.37	$881.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.31 / $135.75 / $202.86	Professional	26	$63.31	$135.75	$202.86
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $174.79 / $323.99 / $1,087.22	Professional		$174.79	$323.99	$1,087.22
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $55.62 / $90.26 / $293.18	Professional	26	$55.62	$90.26	$293.18
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $434.48 / $561.91 / $561.91	Facility	26	$434.48	$561.91	$561.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $238.13 / $422.07 / $2,293.84	Professional		$238.13	$422.07	$2,293.84
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $63.39 / $80.92 / $523.40	Professional	26	$63.39	$80.92	$523.40
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $193.79 / $199.44 / $332.94	Facility	26	$193.79	$199.44	$332.94
Midlands Facility/Professional Professional Modifier Low / Median / High Price $379.47 / $548.63 / $734.00	Professional		$379.47	$548.63	$734.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $59.64 / $184.56 / $326.98	Professional		$59.64	$184.56	$326.98
United Facility/Professional Professional Modifier Low / Median / High Price $225.91 / $280.63 / $496.89	Professional		$225.91	$280.63	$496.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.14 / $76.41 / $141.68	Professional	26	$62.14	$76.41	$141.68
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $303.20 / $383.80 / $451.50	Professional		$303.20	$383.80	$451.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $90.22 / $114.20 / $134.40	Professional	26	$90.22	$114.20	$134.40