Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $204.17 / $204.17 / $204.17	Facility	26	$204.17	$204.17	$204.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $204.17 / $446.68	Professional		$162.18	$204.17	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $389.05 / $489.78	Professional		$269.15	$389.05	$489.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $239.88 / $562.34	Professional		$165.96	$239.88	$562.34
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $204.17 / $407.38	Professional	26	$134.90	$204.17	$407.38
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $660.69 / $660.69 / $660.69	Facility	26	$660.69	$660.69	$660.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $398.11 / $1,348.96	Professional		$177.83	$398.11	$1,348.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $446.68 / $524.81	Professional		$295.12	$446.68	$524.81
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $245.47 / $346.74 / $398.11	Professional	26	$245.47	$346.74	$398.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $398.11 / $501.19	Professional		$354.81	$398.11	$501.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $208.93 / $436.52	Professional		$63.10	$208.93	$436.52
United Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $323.59 / $524.81	Professional		$186.21	$323.59	$524.81
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $426.58	Professional		$363.08	$363.08	$426.58