Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $165.96 / $181.97	Facility	26	$83.18	$165.96	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $323.59 / $1,174.90	Professional		$208.93	$323.59	$1,174.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $104.71 / $323.59	Professional	26	$74.13	$104.71	$323.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $269.15 / $275.42 / $281.84	Facility	26	$269.15	$275.42	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $724.44 / $912.01	Professional		$436.52	$724.44	$912.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $194.98 / $245.47	Professional	26	$109.65	$194.98	$245.47
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $524.81 / $1,318.26	Professional		$269.15	$524.81	$1,318.26
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $144.54 / $354.81	Professional	26	$79.43	$144.54	$354.81
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 $338.84 / $575.44 / $2,884.03	Professional		$338.84	$575.44	$2,884.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $131.83 / $537.03	Professional	26	$87.10	$131.83	$537.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $776.25 / $954.99	Professional		$512.86	$776.25	$954.99
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $199.53 / $263.03	Professional	26	$169.82	$199.53	$263.03
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $281.84 / $281.84 / $281.84	Facility	26	$281.84	$281.84	$281.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $645.65 / $954.99	Professional		$630.96	$645.65	$954.99
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $181.97 / $229.09	Professional	26	$154.88	$181.97	$229.09
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $218.78 / $501.19	Professional		$87.10	$218.78	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $436.52 / $794.33	Professional		$316.23	$436.52	$794.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $109.65 / $223.87	Professional	26	$87.10	$109.65	$223.87
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $575.44 / $676.08	Professional		$575.44	$575.44	$676.08
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $162.18 / $162.18 / $190.55	Professional	26	$162.18	$162.18	$190.55