Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.59 / $139.61 / $257.68	Facility	26	$68.59	$139.61	$257.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.32 / $107.68 / $157.08	Professional		$94.32	$107.68	$157.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $136.32 / $140.41 / $144.50	Facility	26	$136.32	$140.41	$144.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.25 / $259.86 / $350.27	Professional		$117.25	$259.86	$350.27
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $98.16 / $181.04 / $527.45	Professional		$98.16	$181.04	$527.45
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.27 / $65.73 / $216.43	Professional	26	$40.27	$65.73	$216.43
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $101.97 / $195.30 / $195.30	Facility	26	$101.97	$195.30	$195.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $115.27 / $204.65 / $1,286.55	Professional		$115.27	$204.65	$1,286.55
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $140.41 / $144.50 / $240.00	Facility	26	$140.41	$144.50	$240.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $190.43 / $236.96 / $376.99	Professional		$190.43	$236.96	$376.99
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $43.34 / $82.02 / $189.67	Professional		$43.34	$82.02	$189.67
United Facility/Professional Professional Modifier Low / Median / High Price $107.65 / $139.38 / $234.11	Professional		$107.65	$139.38	$234.11
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $150.18 / $190.10 / $223.70	Professional		$150.18	$190.10	$223.70