Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $45.71 / $288.40	Facility	26	$45.71	$45.71	$288.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $147.91 / $407.38	Professional		$117.49	$147.91	$407.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $165.96 / $173.78 / $177.83	Facility	26	$165.96	$173.78	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $346.74 / $524.81	Professional		$194.98	$346.74	$524.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $239.88 / $1,202.26	Professional		$131.83	$239.88	$1,202.26
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $85.11 / $407.38	Professional	26	$47.86	$85.11	$407.38
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $173.78 / $239.88 / $239.88	Facility	26	$173.78	$239.88	$239.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $309.03 / $3,090.30	Professional		$158.49	$309.03	$3,090.30
Midlands Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $363.08 / $645.65	Professional		$281.84	$363.08	$645.65
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $125.89 / $158.49	Professional	26	$102.33	$125.89	$158.49
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $177.83 / $177.83 / $177.83	Facility	26	$177.83	$177.83	$177.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $338.84 / $645.65	Professional		$309.03	$338.84	$645.65
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $109.65 / $245.47	Professional		$52.48	$109.65	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $213.80 / $416.87	Professional		$141.25	$213.80	$416.87
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $288.40	Professional		$245.47	$245.47	$288.40