Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $138.57 / $216.96 / $401.58	Facility	26	$138.57	$216.96	$401.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.71 / $234.71 / $1,940.95	Professional		$234.71	$234.71	$1,940.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $217.17 / $223.69 / $230.20	Facility	26	$217.17	$223.69	$230.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $560.04 / $618.23 / $772.79	Professional		$560.04	$618.23	$772.79
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $229.21 / $430.26 / $1,054.10	Professional		$229.21	$430.26	$1,054.10
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.49 / $104.53 / $226.92	Professional	26	$63.49	$104.53	$226.92
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $223.69 / $223.69 / $223.69	Facility	26	$223.69	$223.69	$223.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $289.08 / $445.27 / $1,377.73	Professional		$289.08	$445.27	$1,377.73
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $223.69 / $230.20 / $380.04	Facility	26	$223.69	$230.20	$380.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $501.40 / $654.00 / $837.58	Professional		$501.40	$654.00	$837.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $68.02 / $246.35 / $452.79	Professional		$68.02	$246.35	$452.79
United Facility/Professional Professional Modifier Low / Median / High Price $273.57 / $328.28 / $547.27	Professional		$273.57	$328.28	$547.27
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $354.95 / $449.30 / $528.60	Professional		$354.95	$449.30	$528.60