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 $227.80 / $353.08 / $1,267.16	Professional		$227.80	$353.08	$1,267.16
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 $457.96 / $584.10 / $730.13	Professional		$457.96	$584.10	$730.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $244.56 / $337.25 / $590.32	Professional		$244.56	$337.25	$590.32
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $75.93 / $105.35 / $188.99	Professional	26	$75.93	$105.35	$188.99
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 $222.20 / $307.38 / $765.78	Professional		$222.20	$307.38	$765.78
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 $338.69 / $480.59 / $675.53	Professional		$338.69	$480.59	$675.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $74.22 / $229.67 / $409.96	Professional		$74.22	$229.67	$409.96
United Facility/Professional Professional Modifier Low / Median / High Price $218.24 / $248.01 / $407.72	Professional		$218.24	$248.01	$407.72
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $362.22 / $458.50 / $539.40	Professional		$362.22	$458.50	$539.40