Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $141.25 / $141.25	Facility	26	$70.79	$141.25	$141.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $302.00 / $1,202.26	Professional		$213.80	$302.00	$1,202.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $245.47 / $257.04 / $263.03	Facility	26	$245.47	$257.04	$263.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $616.60 / $776.25	Professional		$234.42	$616.60	$776.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $380.19 / $602.56	Professional		$229.09	$380.19	$602.56
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $141.25 / $537.03	Professional	26	$77.62	$141.25	$537.03
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $257.04 / $354.81 / $354.81	Facility	26	$257.04	$354.81	$354.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $389.05 / $1,698.24	Professional		$199.53	$389.05	$1,698.24
Midlands Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $549.54 / $660.69	Professional		$354.81	$549.54	$660.69
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $181.97 / $229.09	Professional	26	$158.49	$181.97	$229.09
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $263.03 / $263.03 / $263.03	Facility	26	$263.03	$263.03	$263.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $602.56 / $741.31	Professional		$436.52	$602.56	$741.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $190.55 / $436.52	Professional		$81.28	$190.55	$436.52
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $295.12 / $562.34	Professional		$194.98	$295.12	$562.34
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $537.03	Professional		$457.09	$457.09	$537.03