Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $20.89 / $91.20	Facility	26	$20.89	$20.89	$91.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $131.83 / $288.40	Professional		$104.71	$131.83	$288.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $54.95 / $56.23	Facility	26	$53.70	$54.95	$56.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $323.59 / $398.11	Professional		$104.71	$323.59	$398.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $162.18 / $389.05	Professional		$109.65	$162.18	$389.05
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $32.36 / $72.44	Professional	26	$22.39	$32.36	$72.44
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $109.65 / $109.65	Facility	26	$57.54	$109.65	$109.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $186.21 / $891.25	Professional		$77.62	$186.21	$891.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $263.03 / $346.74	Professional		$141.25	$263.03	$346.74
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $51.29 / $58.88	Professional	26	$36.31	$51.29	$58.88
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $56.23 / $56.23	Facility	26	$56.23	$56.23	$56.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $141.25 / $346.74	Professional		$125.89	$141.25	$346.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $123.03 / $239.88	Professional		$25.12	$123.03	$239.88
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $154.88 / $371.54	Professional		$75.86	$154.88	$371.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $269.15	Professional		$229.09	$229.09	$269.15