Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.19 / $248.18 / $458.00	Facility	26	$123.19	$248.18	$458.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $328.68 / $425.00 / $700.00	Professional		$328.68	$425.00	$700.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $241.80 / $249.05 / $256.31	Facility	26	$241.80	$249.05	$256.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $444.22 / $813.19 / $1,322.76	Professional		$444.22	$813.19	$1,322.76
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $291.08 / $501.42 / $1,588.04	Professional		$291.08	$501.42	$1,588.04
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $71.20 / $116.92 / $304.68	Professional	26	$71.20	$116.92	$304.68
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $556.32 / $720.40 / $720.40	Facility	26	$556.32	$720.40	$720.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $435.52 / $713.77 / $3,350.26	Professional		$435.52	$713.77	$3,350.26
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $249.05 / $256.31 / $427.56	Facility	26	$249.05	$256.31	$427.56
Midlands Facility/Professional Professional Modifier Low / Median / High Price $637.29 / $814.31 / $1,135.54	Professional		$637.29	$814.31	$1,135.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $78.73 / $340.25 / $584.67	Professional		$78.73	$340.25	$584.67
United Facility/Professional Professional Modifier Low / Median / High Price $399.22 / $544.40 / $1,122.01	Professional		$399.22	$544.40	$1,122.01
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $589.89 / $746.70 / $878.40	Professional		$589.89	$746.70	$878.40