Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.99 / $48.98 / $54.95	Facility	26	$23.99	$48.98	$54.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $85.11 / $371.54	Professional		$58.88	$85.11	$371.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.10 / $89.13 / $91.20	Facility	26	$87.10	$89.13	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $165.96 / $204.17	Professional		$87.10	$165.96	$204.17
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $151.36 / $426.58	Professional		$67.61	$151.36	$426.58
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $53.70 / $245.47	Professional	26	$27.54	$53.70	$245.47
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $169.82 / $169.82	Facility	26	$89.13	$169.82	$169.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $128.82 / $537.03	Professional		$69.18	$128.82	$537.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $162.18 / $218.78	Professional		$138.04	$162.18	$218.78
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $63.10 / $87.10	Professional	26	$56.23	$63.10	$87.10
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $91.20 / $91.20 / $91.20	Facility	26	$91.20	$91.20	$91.20
Midlands Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $162.18 / $194.98	Professional		$120.23	$162.18	$194.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $58.88 / $117.49	Professional		$28.18	$58.88	$117.49
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $83.18 / $154.88	Professional		$66.07	$83.18	$154.88
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $144.54	Professional		$123.03	$123.03	$144.54