Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $39.81 / $60.26	Facility	26	$39.81	$39.81	$60.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $338.84 / $537.03	Professional		$281.84	$338.84	$537.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $128.82 / $134.90	Facility	26	$125.89	$128.82	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $851.14 / $1,071.52	Professional		$426.58	$851.14	$1,071.52
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $512.86 / $1,778.28	Professional		$316.23	$512.86	$1,778.28
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $69.18 / $245.47	Professional	26	$46.77	$69.18	$245.47
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $204.17 / $204.17	Facility	26	$128.82	$204.17	$204.17
Medica Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $616.60 / $2,398.83	Professional		$371.54	$616.60	$2,398.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $851.14 / $912.01	Professional		$691.83	$851.14	$912.01
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $104.71 / $112.20	Professional	26	$91.20	$104.71	$112.20
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $134.90 / $134.90 / $134.90	Facility	26	$134.90	$134.90	$134.90
Midlands Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $831.76 / $912.01	Professional		$691.83	$831.76	$912.01
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $316.23 / $630.96	Professional		$46.77	$316.23	$630.96
United Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $478.63 / $954.99	Professional		$371.54	$478.63	$954.99
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $602.56 / $707.95	Professional		$602.56	$602.56	$707.95