Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $87.10 / $199.53	Facility	26	$83.18	$87.10	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $177.83 / $416.87	Professional		$134.90	$177.83	$416.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $93.33 / $537.03	Professional	26	$56.23	$93.33	$537.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $169.82 / $173.78 / $181.97	Facility	26	$169.82	$173.78	$181.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $398.11 / $537.03	Professional		$213.80	$398.11	$537.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $213.80 / $269.15	Professional	26	$74.13	$213.80	$269.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $288.40 / $660.69	Professional		$154.88	$288.40	$660.69
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $123.03 / $218.78	Professional	26	$87.10	$123.03	$218.78
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $223.87 / $426.58 / $426.58	Facility	26	$223.87	$426.58	$426.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $338.84 / $3,090.30	Professional		$186.21	$338.84	$3,090.30
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $120.23 / $676.08	Professional	26	$61.66	$120.23	$676.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $436.52 / $630.96	Professional		$323.59	$436.52	$630.96
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $199.53 / $239.88	Professional	26	$125.89	$199.53	$239.88
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $181.97 / $181.97 / $181.97	Facility	26	$181.97	$181.97	$181.97
Midlands Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $363.08 / $630.96	Professional		$295.12	$363.08	$630.96
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $131.83 / $239.88	Professional	26	$107.15	$131.83	$239.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $169.82 / $398.11	Professional		$104.71	$169.82	$398.11
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $234.42 / $457.09	Professional		$173.78	$234.42	$457.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $112.20 / $190.55	Professional	26	$61.66	$112.20	$190.55
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $295.12 / $346.74	Professional		$295.12	$295.12	$346.74
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $158.49 / $186.21	Professional	26	$158.49	$158.49	$186.21