Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $155.34 / $382.86 / $706.83	Facility	26	$155.34	$382.86	$706.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $292.62 / $463.23	Professional		$275.00	$292.62	$463.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $374.42 / $385.65 / $396.89	Facility	26	$374.42	$385.65	$396.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $531.17 / $1,103.05 / $1,378.81	Professional		$531.17	$1,103.05	$1,378.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $408.70 / $609.41 / $1,058.63	Professional		$408.70	$609.41	$1,058.63
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $110.52 / $159.57 / $232.03	Professional	26	$110.52	$159.57	$232.03
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $864.48 / $1,108.64 / $1,108.64	Facility	26	$864.48	$1,108.64	$1,108.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $504.14 / $679.62 / $2,146.96	Professional		$504.14	$679.62	$2,146.96
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $385.65 / $396.89 / $657.48	Facility	26	$385.65	$396.89	$657.48
Midlands Facility/Professional Professional Modifier Low / Median / High Price $549.58 / $679.62 / $1,122.76	Professional		$549.58	$679.62	$1,122.76
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $400.40 / $400.40 / $1,766.50	Professional		$400.40	$400.40	$1,766.50
United Facility/Professional Professional Modifier Low / Median / High Price $500.72 / $652.04 / $1,144.24	Professional		$500.72	$652.04	$1,144.24
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $712.34 / $901.70 / $1,060.80	Professional		$712.34	$901.70	$1,060.80