Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.95 / $242.25 / $448.17	Facility	26	$117.95	$242.25	$448.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $369.25 / $760.36 / $2,729.41	Professional		$369.25	$760.36	$2,729.41
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $243.47 / $250.77 / $258.08	Facility	26	$243.47	$250.77	$258.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $798.06 / $1,288.44 / $1,610.55	Professional		$798.06	$1,288.44	$1,610.55
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $317.77 / $537.32 / $939.02	Professional		$317.77	$537.32	$939.02
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $65.98 / $107.61 / $165.00	Professional	26	$65.98	$107.61	$165.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $250.77 / $250.77 / $250.77	Facility	26	$250.77	$250.77	$250.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $338.61 / $650.37 / $1,423.18	Professional		$338.61	$650.37	$1,423.18
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $250.77 / $258.08 / $396.06	Facility	26	$250.77	$258.08	$396.06
Midlands Facility/Professional Professional Modifier Low / Median / High Price $472.43 / $1,002.24 / $1,305.05	Professional		$472.43	$1,002.24	$1,305.05
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $71.63 / $484.03 / $897.68	Professional		$71.63	$484.03	$897.68
United Facility/Professional Professional Modifier Low / Median / High Price $404.01 / $564.61 / $874.66	Professional		$404.01	$564.61	$874.66
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $794.50 / $1,005.70 / $1,183.20	Professional		$794.50	$1,005.70	$1,183.20