Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $91.20 / $147.91	Facility	26	$61.66	$91.20	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $223.87 / $575.44	Professional		$177.83	$223.87	$575.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $204.17 / $208.93 / $213.80	Facility	26	$204.17	$208.93	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $512.86 / $645.65	Professional		$295.12	$512.86	$645.65
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $346.74 / $1,258.93	Professional		$213.80	$346.74	$1,258.93
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $91.20 / $346.74	Professional	26	$63.10	$91.20	$346.74
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $489.78 / $645.65 / $645.65	Facility	26	$489.78	$645.65	$645.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $575.44 / $1,445.44	Professional		$263.03	$575.44	$1,445.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $524.81 / $676.08	Professional		$426.58	$524.81	$676.08
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $158.49 / $208.93	Professional	26	$134.90	$158.49	$208.93
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $501.19 / $933.25	Professional		$426.58	$501.19	$933.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $151.36 / $363.08	Professional		$69.18	$151.36	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $398.11 / $870.96	Professional		$245.47	$398.11	$870.96
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $478.63 / $562.34	Professional		$478.63	$478.63	$562.34