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 $181.97 / $263.03 / $1,548.82	Professional		$181.97	$263.03	$1,548.82
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 $478.63 / $602.56 / $741.31	Professional		$478.63	$602.56	$741.31
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $371.54 / $588.84	Professional		$245.47	$371.54	$588.84
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $104.71 / $194.98	Professional	26	$91.20	$104.71	$194.98
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 $218.78 / $309.03 / $676.08	Professional		$218.78	$309.03	$676.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $524.81 / $691.83	Professional		$346.74	$524.81	$691.83
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 $588.84 / $588.84 / $660.69	Professional		$588.84	$588.84	$660.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $181.97 / $416.87	Professional		$75.86	$181.97	$416.87
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $251.19 / $467.74	Professional		$218.78	$251.19	$467.74
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $457.09 / $537.03	Professional		$363.08	$457.09	$537.03