Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.10 / $87.10 / $165.96	Facility	26	$87.10	$87.10	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $234.42 / $457.09	Professional		$158.49	$234.42	$457.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $295.12 / $302.00 / $309.03	Facility	26	$295.12	$302.00	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $616.60 / $776.25	Professional		$199.53	$616.60	$776.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $354.81 / $478.63	Professional		$234.42	$354.81	$478.63
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $151.36 / $229.09	Professional	26	$97.72	$151.36	$229.09
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $302.00 / $457.09 / $457.09	Facility	26	$302.00	$457.09	$457.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $316.23 / $1,698.24	Professional		$208.93	$316.23	$1,698.24
Midlands Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $549.54 / $645.65	Professional		$426.58	$549.54	$645.65
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $234.42 / $302.00	Professional	26	$199.53	$234.42	$302.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $309.03 / $309.03 / $309.03	Facility	26	$309.03	$309.03	$309.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $407.38 / $741.31	Professional		$338.84	$407.38	$741.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $426.58 / $707.95	Professional		$363.08	$426.58	$707.95
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $257.04 / $467.74	Professional		$190.55	$257.04	$467.74
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $446.68 / $524.81	Professional		$354.81	$446.68	$524.81