Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $102.33 / $104.71	Facility	26	$52.48	$102.33	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $158.49 / $691.83	Professional		$114.82	$158.49	$691.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $162.18 / $169.82 / $173.78	Facility	26	$162.18	$169.82	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $426.58 / $537.03	Professional		$128.82	$426.58	$537.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $269.15 / $436.52	Professional		$158.49	$269.15	$436.52
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $104.71 / $181.97	Professional	26	$58.88	$104.71	$181.97
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $169.82 / $281.84 / $281.84	Facility	26	$169.82	$281.84	$281.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $213.80 / $933.25	Professional		$120.23	$213.80	$933.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $323.59 / $398.11	Professional		$234.42	$323.59	$398.11
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $134.90 / $154.88	Professional	26	$107.15	$134.90	$154.88
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $173.78 / $173.78 / $173.78	Facility	26	$173.78	$173.78	$173.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $398.11 / $436.52	Professional		$263.03	$398.11	$436.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $151.36 / $331.13	Professional		$70.79	$151.36	$331.13
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $158.49 / $309.03	Professional		$117.49	$158.49	$309.03
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $323.59 / $380.19	Professional		$323.59	$323.59	$380.19