Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $90.34 / $170.18 / $313.01	Facility	26	$90.34	$170.18	$313.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.40 / $120.04 / $214.37	Professional		$108.40	$120.04	$214.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $172.88 / $178.07 / $183.25	Facility	26	$172.88	$178.07	$183.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $156.50 / $292.44 / $468.45	Professional		$156.50	$292.44	$468.45
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $112.19 / $205.20 / $852.65	Professional		$112.19	$205.20	$852.65
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $50.04 / $80.81 / $239.08	Professional	26	$50.04	$80.81	$239.08
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $178.07 / $243.24 / $243.24	Facility	26	$178.07	$243.24	$243.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $142.36 / $255.50 / $3,109.00	Professional		$142.36	$255.50	$3,109.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $178.07 / $183.25 / $290.58	Facility	26	$178.07	$183.25	$290.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $234.41 / $296.70 / $805.00	Professional		$234.41	$296.70	$805.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $167.00 / $167.00 / $516.70	Professional		$167.00	$167.00	$516.70
United Facility/Professional Professional Modifier Low / Median / High Price $129.41 / $168.53 / $312.98	Professional		$129.41	$168.53	$312.98
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $170.96 / $216.40 / $254.60	Professional		$170.96	$216.40	$254.60