Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.85 / $36.31 / $38.90	Facility	26	$15.85	$36.31	$38.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $104.71 / $407.38	Professional		$77.62	$104.71	$407.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $58.88 / $60.26	Facility	26	$56.23	$58.88	$60.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $218.78 / $269.15	Professional		$91.20	$218.78	$269.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $123.03 / $269.15	Professional		$81.28	$123.03	$269.15
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $28.18 / $75.86	Professional	26	$16.98	$28.18	$75.86
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $100.00 / $100.00	Facility	26	$58.88	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $141.25 / $630.96	Professional		$79.43	$141.25	$630.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $181.97 / $239.88	Professional		$147.91	$181.97	$239.88
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $41.69 / $50.12	Professional	26	$36.31	$41.69	$50.12
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $60.26 / $60.26	Facility	26	$60.26	$60.26	$60.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $154.88 / $239.88	Professional		$144.54	$154.88	$239.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $74.13 / $158.49	Professional		$18.62	$74.13	$158.49
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $100.00 / $194.98	Professional		$77.62	$100.00	$194.98
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $181.97	Professional		$154.88	$154.88	$181.97