Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $93.33 / $123.03	Facility	26	$57.54	$93.33	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $281.84 / $602.56	Professional		$218.78	$281.84	$602.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $64.57 / $177.83	Professional	26	$53.70	$64.57	$177.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $181.97 / $186.21 / $190.55	Facility	26	$181.97	$186.21	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $602.56 / $758.58	Professional		$363.08	$602.56	$758.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $131.83 / $165.96	Professional	26	$74.13	$131.83	$165.96
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $407.38 / $1,122.02	Professional		$223.87	$407.38	$1,122.02
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $95.50 / $239.88	Professional	26	$53.70	$95.50	$239.88
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $416.87 / $537.03 / $537.03	Facility	26	$416.87	$537.03	$537.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $501.19 / $2,089.30	Professional		$281.84	$501.19	$2,089.30
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $89.13 / $398.11	Professional	26	$60.26	$89.13	$398.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $691.83 / $758.58	Professional		$457.09	$691.83	$758.58
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $131.83 / $177.83	Professional	26	$114.82	$131.83	$177.83
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $190.55 / $190.55 / $190.55	Facility	26	$190.55	$190.55	$190.55
Midlands Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $562.34 / $758.58	Professional		$537.03	$562.34	$758.58
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $131.83 / $194.98	Professional	26	$107.15	$131.83	$194.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $194.98 / $416.87	Professional		$58.88	$194.98	$416.87
United Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $354.81 / $676.08	Professional		$269.15	$354.81	$676.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $74.13 / $151.36	Professional	26	$60.26	$74.13	$151.36
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $478.63 / $562.34	Professional		$478.63	$478.63	$562.34
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $109.65 / $128.82	Professional	26	$109.65	$109.65	$128.82