Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.37 / $68.37 / $68.37	Facility	26	$68.37	$68.37	$68.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.34 / $358.61 / $906.40	Professional		$215.34	$358.61	$906.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $164.15 / $169.07 / $174.00	Facility	26	$164.15	$169.07	$174.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $486.17 / $591.08 / $738.85	Professional		$486.17	$591.08	$738.85
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $246.25 / $339.06 / $968.44	Professional		$246.25	$339.06	$968.44
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.08 / $79.29 / $218.99	Professional	26	$57.08	$79.29	$218.99
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $169.07 / $169.07 / $169.07	Facility	26	$169.07	$169.07	$169.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $246.08 / $335.57 / $851.38	Professional		$246.08	$335.57	$851.38
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $169.07 / $174.00 / $307.74	Facility	26	$169.07	$174.00	$307.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $393.05 / $519.75 / $792.55	Professional		$393.05	$519.75	$792.55
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $55.88 / $230.86 / $417.58	Professional		$55.88	$230.86	$417.58
United Facility/Professional Professional Modifier Low / Median / High Price $246.08 / $291.32 / $915.75	Professional		$246.08	$291.32	$915.75
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $366.09 / $463.40 / $545.20	Professional		$366.09	$463.40	$545.20