Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $121.51 / $236.01 / $437.07	Facility	26	$121.51	$236.01	$437.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.44 / $166.08 / $265.63	Professional		$151.44	$166.08	$265.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.89 / $71.78 / $118.18	Professional	26	$64.89	$71.78	$118.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $231.26 / $238.20 / $245.14	Facility	26	$231.26	$238.20	$245.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.34 / $409.57 / $511.96	Professional		$177.34	$409.57	$511.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.79 / $175.31 / $219.14	Professional	26	$84.79	$175.31	$219.14
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $154.90 / $260.07 / $548.83	Professional		$154.90	$260.07	$548.83
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $70.62 / $116.59 / $222.00	Professional	26	$70.62	$116.59	$222.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $238.20 / $343.65 / $343.65	Facility	26	$238.20	$343.65	$343.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $166.92 / $273.00 / $1,115.94	Professional		$166.92	$273.00	$1,115.94
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $77.00 / $100.27 / $476.34	Professional	26	$77.00	$100.27	$476.34
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $238.20 / $245.14 / $425.22	Facility	26	$238.20	$245.14	$425.22
Midlands Facility/Professional Professional Modifier Low / Median / High Price $273.00 / $358.51 / $486.32	Professional		$273.00	$358.51	$486.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $231.50 / $231.50 / $483.80	Professional		$231.50	$231.50	$483.80
United Facility/Professional Professional Modifier Low / Median / High Price $158.18 / $199.81 / $382.64	Professional		$158.18	$199.81	$382.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.00 / $96.14 / $177.32	Professional	26	$77.00	$96.14	$177.32
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $245.45 / $310.70 / $365.50	Professional		$245.45	$310.70	$365.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $106.33 / $134.60 / $158.30	Professional	26	$106.33	$134.60	$158.30