Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $114.82 / $158.49	Facility	26	$102.33	$114.82	$158.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $426.58 / $1,819.70	Professional		$288.40	$426.58	$1,819.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $354.81 / $363.08 / $371.54	Facility	26	$354.81	$363.08	$371.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $676.08 / $933.25	Professional		$398.11	$676.08	$933.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $426.58 / $2,187.76	Professional		$251.19	$426.58	$2,187.76
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $186.21 / $776.25	Professional	26	$102.33	$186.21	$776.25
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $794.33 / $1,023.29 / $1,023.29	Facility	26	$794.33	$1,023.29	$1,023.29
Medica Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $602.56 / $3,162.28	Professional		$346.74	$602.56	$3,162.28
Midlands Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $851.14 / $954.99	Professional		$562.34	$851.14	$954.99
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $218.78 / $251.19 / $371.54	Professional	26	$218.78	$251.19	$371.54
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $371.54 / $371.54 / $371.54	Facility	26	$371.54	$371.54	$371.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $660.69 / $933.25	Professional		$630.96	$660.69	$933.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $229.09 / $478.63	Professional		$112.20	$229.09	$478.63
United Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $467.74 / $933.25	Professional		$323.59	$467.74	$933.25
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $630.96 / $741.31	Professional		$630.96	$630.96	$741.31