Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.77 / $216.71 / $401.00	Facility	26	$89.77	$216.71	$401.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.82 / $215.44 / $864.73	Professional		$138.82	$215.44	$864.73
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $229.13 / $236.00 / $242.88	Facility	26	$229.13	$236.00	$242.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $292.37 / $351.39 / $439.24	Professional		$292.37	$351.39	$439.24
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $149.38 / $206.70 / $770.60	Professional		$149.38	$206.70	$770.60
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $75.93 / $105.35 / $355.49	Professional	26	$75.93	$105.35	$355.49
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $236.00 / $236.00 / $236.00	Facility	26	$236.00	$236.00	$236.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $156.13 / $212.91 / $531.23	Professional		$156.13	$212.91	$531.23
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $236.00 / $242.88 / $410.16	Facility	26	$236.00	$242.88	$410.16
Midlands Facility/Professional Professional Modifier Low / Median / High Price $264.07 / $320.23 / $509.46	Professional		$264.07	$320.23	$509.46
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $70.27 / $132.71 / $249.95	Professional		$70.27	$132.71	$249.95
United Facility/Professional Professional Modifier Low / Median / High Price $156.13 / $184.83 / $279.45	Professional		$156.13	$184.83	$279.45
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $219.07 / $277.30 / $326.30	Professional		$219.07	$277.30	$326.30