Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $109.65 / $363.08	Facility	26	$89.13	$109.65	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $151.36 / $933.25	Professional		$112.20	$151.36	$933.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $229.09 / $234.42 / $245.47	Facility	26	$229.09	$234.42	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $363.08 / $446.68	Professional		$323.59	$363.08	$446.68
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $223.87 / $776.25	Professional		$151.36	$223.87	$776.25
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $104.71 / $363.08	Professional	26	$91.20	$104.71	$363.08
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $234.42 / $234.42 / $338.84	Facility	26	$234.42	$234.42	$338.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $213.80 / $512.86	Professional		$154.88	$213.80	$512.86
Midlands Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $323.59 / $549.54	Professional		$275.42	$323.59	$549.54
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $158.49 / $281.84	Professional	26	$141.25	$158.49	$281.84
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $245.47 / $245.47 / $245.47	Facility	26	$245.47	$245.47	$245.47
Midlands Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $354.81 / $398.11	Professional		$354.81	$354.81	$398.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $138.04 / $257.04	Professional		$70.79	$138.04	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $186.21 / $323.59	Professional		$154.88	$186.21	$323.59
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $275.42 / $323.59	Professional		$218.78	$275.42	$323.59