Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.43 / $193.07 / $357.00	Facility	26	$96.43	$193.07	$357.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $196.53 / $218.78 / $405.86	Professional		$196.53	$218.78	$405.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $60.02 / $99.59	Professional	26	$55.00	$60.02	$99.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $188.67 / $194.33 / $199.99	Facility	26	$188.67	$194.33	$199.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $297.11 / $479.91 / $888.49	Professional		$297.11	$479.91	$888.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.64 / $136.52 / $203.99	Professional	26	$63.64	$136.52	$203.99
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $176.77 / $327.72 / $1,084.32	Professional		$176.77	$327.72	$1,084.32
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $55.90 / $90.77 / $284.38	Professional	26	$55.90	$90.77	$284.38
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $436.88 / $565.04 / $565.04	Facility	26	$436.88	$565.04	$565.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $238.49 / $423.72 / $2,293.84	Professional		$238.49	$423.72	$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 $194.33 / $199.99 / $334.74	Facility	26	$194.33	$199.99	$334.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $381.94 / $549.47 / $736.00	Professional		$381.94	$549.47	$736.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $59.98 / $186.39 / $330.69	Professional		$59.98	$186.39	$330.69
United Facility/Professional Professional Modifier Low / Median / High Price $226.25 / $281.06 / $523.83	Professional		$226.25	$281.06	$523.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.39 / $76.84 / $140.44	Professional	26	$63.39	$76.84	$140.44
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $306.76 / $388.30 / $456.80	Professional		$306.76	$388.30	$456.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $90.77 / $114.90 / $135.10	Professional	26	$90.77	$114.90	$135.10