Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $89.13 / $131.83	Facility	26	$89.13	$89.13	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $363.08 / $1,230.27	Professional		$288.40	$363.08	$1,230.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $295.12 / $302.00 / $309.03	Facility	26	$295.12	$302.00	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $812.83 / $1,023.29	Professional		$467.74	$812.83	$1,023.29
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $549.54 / $1,949.84	Professional		$338.84	$549.54	$1,949.84
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $134.90 / $501.19	Professional	26	$93.33	$134.90	$501.19
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $724.44 / $933.25 / $933.25	Facility	26	$724.44	$933.25	$933.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $758.58 / $2,290.87	Professional		$416.87	$758.58	$2,290.87
Midlands Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $812.83 / $1,071.52	Professional		$676.08	$812.83	$1,071.52
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $194.98 / $229.09 / $302.00	Professional	26	$194.98	$229.09	$302.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $309.03 / $309.03 / $309.03	Facility	26	$309.03	$309.03	$309.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $794.33 / $1,479.11	Professional		$676.08	$794.33	$1,479.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $245.47 / $562.34	Professional		$100.00	$245.47	$562.34
United Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $630.96 / $1,202.26	Professional		$389.05	$630.96	$1,202.26
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $891.25	Professional		$758.58	$758.58	$891.25