Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $115.68 / $178.71 / $329.42	Facility	26	$115.68	$178.71	$329.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.62 / $143.28 / $301.99	Professional		$109.62	$143.28	$301.99
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $174.66 / $179.90 / $185.14	Facility	26	$174.66	$179.90	$185.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $236.26 / $282.23 / $353.69	Professional		$236.26	$282.23	$353.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $99.01 / $194.43 / $446.58	Professional		$99.01	$194.43	$446.58
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.34 / $83.87 / $159.97	Professional	26	$51.34	$83.87	$159.97
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $179.90 / $296.93 / $296.93	Facility	26	$179.90	$296.93	$296.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $126.17 / $236.26 / $1,548.00	Professional		$126.17	$236.26	$1,548.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $179.90 / $185.14 / $303.42	Facility	26	$179.90	$185.14	$303.42
Midlands Facility/Professional Professional Modifier Low / Median / High Price $209.54 / $250.16 / $353.69	Professional		$209.54	$250.16	$353.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $232.00 / $279.50 / $355.90	Professional		$232.00	$279.50	$355.90
United Facility/Professional Professional Modifier Low / Median / High Price $122.74 / $155.94 / $266.55	Professional		$122.74	$155.94	$266.55
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $189.60 / $189.60 / $223.00	Professional		$189.60	$189.60	$223.00