Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $92.40 / $185.45 / $342.84	Facility	26	$92.40	$185.45	$342.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $226.13 / $275.00 / $413.03	Professional		$226.13	$275.00	$413.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.46 / $57.48 / $95.74	Professional	26	$52.46	$57.48	$95.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $181.41 / $186.85 / $192.29	Facility	26	$181.41	$186.85	$192.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $307.58 / $587.98 / $915.54	Professional		$307.58	$587.98	$915.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.36 / $130.32 / $179.45	Professional	26	$60.36	$130.32	$179.45
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $217.42 / $404.44 / $932.41	Professional		$217.42	$404.44	$932.41
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.14 / $85.85 / $195.03	Professional	26	$53.14	$85.85	$195.03
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $414.72 / $537.20 / $537.20	Facility	26	$414.72	$537.20	$537.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $284.54 / $485.34 / $2,077.23	Professional		$284.54	$485.34	$2,077.23
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $60.88 / $77.72 / $394.61	Professional	26	$60.88	$77.72	$394.61
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $186.85 / $192.29 / $318.95	Facility	26	$186.85	$192.29	$318.95
Midlands Facility/Professional Professional Modifier Low / Median / High Price $439.60 / $541.07 / $816.26	Professional		$439.60	$541.07	$816.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $57.05 / $199.29 / $406.78	Professional		$57.05	$199.29	$406.78
United Facility/Professional Professional Modifier Low / Median / High Price $268.11 / $336.84 / $589.77	Professional		$268.11	$336.84	$589.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.68 / $74.93 / $139.05	Professional	26	$59.68	$74.93	$139.05
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $379.75 / $480.70 / $565.50	Professional		$379.75	$480.70	$565.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $86.19 / $109.10 / $128.30	Professional	26	$86.19	$109.10	$128.30