Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.95 / $88.84 / $267.91	Facility	26	$47.95	$88.84	$267.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.69 / $136.11 / $225.75	Professional		$103.69	$136.11	$225.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $167.00 / $172.01 / $177.02	Facility	26	$167.00	$172.01	$177.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.44 / $277.11 / $461.33	Professional		$154.44	$277.11	$461.33
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $104.55 / $190.23 / $851.88	Professional		$104.55	$190.23	$851.88
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $49.51 / $79.12 / $240.33	Professional	26	$49.51	$79.12	$240.33
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $172.01 / $239.19 / $239.19	Facility	26	$172.01	$239.19	$239.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $134.38 / $245.74 / $3,401.00	Professional		$134.38	$245.74	$3,401.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $172.01 / $177.02 / $287.58	Facility	26	$172.01	$177.02	$287.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $220.79 / $285.79 / $803.00	Professional		$220.79	$285.79	$803.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $154.60 / $154.60 / $510.00	Professional		$154.60	$154.60	$510.00
United Facility/Professional Professional Modifier Low / Median / High Price $124.43 / $159.09 / $486.79	Professional		$124.43	$159.09	$486.79
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $158.79 / $201.00 / $236.40	Professional		$158.79	$201.00	$236.40