Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $177.83 / $177.83	Facility	26	$89.13	$177.83	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $426.58 / $1,778.28	Professional		$281.84	$426.58	$1,778.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $128.82 / $478.63	Professional	26	$83.18	$128.82	$478.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $288.40 / $295.12 / $302.00	Facility	26	$288.40	$295.12	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $676.08 / $933.25	Professional		$416.87	$676.08	$933.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $194.98 / $257.04	Professional	26	$109.65	$194.98	$257.04
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $478.63 / $1,949.84	Professional		$245.47	$478.63	$1,949.84
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $141.25 / $524.81	Professional	26	$77.62	$141.25	$524.81
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $616.60 / $794.33 / $794.33	Facility	26	$616.60	$794.33	$794.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $630.96 / $3,467.37	Professional		$346.74	$630.96	$3,467.37
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $131.83 / $707.95	Professional	26	$91.20	$131.83	$707.95
Midlands Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $870.96 / $1,122.02	Professional		$549.54	$870.96	$1,122.02
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $208.93 / $263.03	Professional	26	$169.82	$208.93	$263.03
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $302.00 / $302.00 / $302.00	Facility	26	$302.00	$302.00	$302.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $645.65 / $1,122.02	Professional		$630.96	$645.65	$1,122.02
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $165.96 / $194.98 / $288.40	Professional	26	$165.96	$194.98	$288.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $194.98 / $457.09	Professional		$85.11	$194.98	$457.09
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $501.19 / $912.01	Professional		$316.23	$501.19	$912.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $123.03 / $269.15	Professional	26	$91.20	$123.03	$269.15
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $616.60 / $724.44	Professional		$616.60	$616.60	$724.44
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $186.21 / $218.78	Professional	26	$186.21	$186.21	$218.78