Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $47.86 / $89.13	Facility	26	$44.67	$47.86	$89.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $173.78 / $588.84	Professional		$97.72	$173.78	$588.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $158.49 / $162.18 / $169.82	Facility	26	$158.49	$162.18	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $281.84 / $354.81	Professional		$128.82	$281.84	$354.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $208.93 / $398.11	Professional		$112.20	$208.93	$398.11
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $93.33 / $194.98	Professional	26	$48.98	$93.33	$194.98
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $162.18 / $223.87 / $223.87	Facility	26	$162.18	$223.87	$223.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $194.98 / $741.31	Professional		$112.20	$194.98	$741.31
Midlands Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $263.03 / $302.00	Professional		$234.42	$263.03	$302.00
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $112.20 / $144.54	Professional	26	$100.00	$112.20	$144.54
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $169.82 / $169.82 / $169.82	Facility	26	$169.82	$169.82	$169.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $281.84 / $309.03	Professional		$239.88	$281.84	$309.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $107.15 / $208.93	Professional		$52.48	$107.15	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $134.90 / $257.04	Professional		$109.65	$134.90	$257.04
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $245.47	Professional		$208.93	$208.93	$245.47