Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.80 / $169.75 / $311.85	Facility	26	$87.80	$169.75	$311.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.59 / $116.51 / $232.82	Professional		$102.59	$116.51	$232.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $170.64 / $175.76 / $180.88	Facility	26	$170.64	$175.76	$180.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $156.44 / $280.19 / $468.45	Professional		$156.44	$280.19	$468.45
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $107.11 / $195.03 / $853.62	Professional		$107.11	$195.03	$853.62
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $49.50 / $79.37 / $218.94	Professional	26	$49.50	$79.37	$218.94
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $175.76 / $245.13 / $245.13	Facility	26	$175.76	$245.13	$245.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $134.43 / $245.89 / $3,099.85	Professional		$134.43	$245.89	$3,099.85
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $175.76 / $180.88 / $288.18	Facility	26	$175.76	$180.88	$288.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $224.91 / $283.61 / $805.00	Professional		$224.91	$283.61	$805.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $158.69 / $158.69 / $516.79	Professional		$158.69	$158.69	$516.79
United Facility/Professional Professional Modifier Low / Median / High Price $125.83 / $159.13 / $487.78	Professional		$125.83	$159.13	$487.78
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $162.82 / $206.10 / $242.50	Professional		$162.82	$206.10	$242.50