Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $7.08 / $48.98	Facility	26	$7.08	$7.08	$48.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $85.11 / $436.52	Professional		$64.57	$85.11	$436.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $27.54 / $28.84	Facility	26	$26.92	$27.54	$28.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $194.98 / $245.47	Professional		$177.83	$194.98	$245.47
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $128.82 / $295.12	Professional		$79.43	$128.82	$295.12
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $13.18 / $33.11	Professional	26	$8.91	$13.18	$33.11
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $27.54 / $27.54 / $70.79	Facility	26	$27.54	$27.54	$70.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $128.82 / $275.42	Professional		$77.62	$128.82	$275.42
Midlands Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $173.78 / $281.84	Professional		$144.54	$173.78	$281.84
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $18.62 / $35.48	Professional	26	$17.38	$18.62	$35.48
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $28.84 / $28.84	Facility	26	$28.84	$28.84	$28.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $199.53	Professional		$190.55	$190.55	$199.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $72.44 / $147.91	Professional		$9.12	$72.44	$147.91
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $91.20 / $194.98	Professional		$75.86	$91.20	$194.98
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $138.04 / $162.18	Professional		$109.65	$138.04	$162.18