Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $145.22 / $145.22 / $447.48	Facility	26	$145.22	$145.22	$447.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.50 / $174.71 / $446.32	Professional		$133.50	$174.71	$446.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $267.38 / $275.39 / $283.42	Facility	26	$267.38	$275.39	$283.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.82 / $444.48 / $555.60	Professional		$177.82	$444.48	$555.60
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $168.00 / $271.58 / $598.29	Professional		$168.00	$271.58	$598.29
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $78.33 / $133.99 / $259.91	Professional	26	$78.33	$133.99	$259.91
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $275.39 / $379.97 / $379.97	Facility	26	$275.39	$379.97	$379.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $186.17 / $287.95 / $1,243.70	Professional		$186.17	$287.95	$1,243.70
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $275.39 / $283.42 / $476.40	Facility	26	$275.39	$283.42	$476.40
Midlands Facility/Professional Professional Modifier Low / Median / High Price $265.00 / $403.48 / $529.85	Professional		$265.00	$403.48	$529.85
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $83.42 / $159.76 / $323.23	Professional		$83.42	$159.76	$323.23
United Facility/Professional Professional Modifier Low / Median / High Price $178.80 / $225.85 / $417.93	Professional		$178.80	$225.85	$417.93
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $265.60 / $336.20 / $395.50	Professional		$265.60	$336.20	$395.50