Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $90.10 / $172.06 / $314.51	Facility	26	$90.10	$172.06	$314.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.58 / $148.28 / $256.43	Professional		$123.58	$148.28	$256.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $167.73 / $172.76 / $177.79	Facility	26	$167.73	$172.76	$177.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $171.92 / $335.88 / $514.01	Professional		$171.92	$335.88	$514.01
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $234.32 / $966.69	Professional		$127.50	$234.32	$966.69
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.03 / $77.90 / $332.20	Professional	26	$48.03	$77.90	$332.20
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $172.76 / $242.28 / $242.28	Facility	26	$172.76	$242.28	$242.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $155.13 / $279.85 / $3,098.01	Professional		$155.13	$279.85	$3,098.01
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $172.76 / $177.79 / $283.38	Facility	26	$172.76	$177.79	$283.38
Midlands Facility/Professional Professional Modifier Low / Median / High Price $267.39 / $328.69 / $804.00	Professional		$267.39	$328.69	$804.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $51.98 / $132.36 / $243.55	Professional		$51.98	$132.36	$243.55
United Facility/Professional Professional Modifier Low / Median / High Price $141.03 / $190.39 / $1,217.24	Professional		$141.03	$190.39	$1,217.24
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $195.29 / $247.20 / $290.80	Professional		$195.29	$247.20	$290.80