Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.12 / $50.12 / $72.44	Facility	26	$50.12	$50.12	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $208.93 / $436.52	Professional		$169.82	$208.93	$436.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $416.87 / $501.19	Professional		$257.04	$416.87	$501.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $234.42 / $5,495.41	Professional		$158.49	$234.42	$5,495.41
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $75.86 / $1,621.81	Professional	26	$51.29	$75.86	$1,621.81
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $234.42 / $234.42 / $234.42	Facility	26	$234.42	$234.42	$234.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $416.87 / $1,318.26	Professional		$186.21	$416.87	$1,318.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $467.74 / $512.86	Professional		$257.04	$467.74	$512.86
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $131.83 / $138.04	Professional	26	$93.33	$131.83	$138.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $416.87 / $512.86	Professional		$371.54	$416.87	$512.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $186.21 / $389.05	Professional		$54.95	$186.21	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $331.13 / $537.03	Professional		$186.21	$331.13	$537.03
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $426.58	Professional		$363.08	$363.08	$426.58