Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $58.88 / $338.84	Facility	26	$58.88	$58.88	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $107.15 / $234.42	Professional		$81.28	$107.15	$234.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $75.86 / $245.47	Professional	26	$58.88	$75.86	$245.47
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $199.53 / $208.93 / $213.80	Facility	26	$199.53	$208.93	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $234.42 / $281.84	Professional		$213.80	$234.42	$281.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $169.82 / $199.53	Professional	26	$158.49	$169.82	$199.53
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $338.84 / $588.84	Professional		$95.50	$338.84	$588.84
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $125.89 / $389.05	Professional	26	$69.18	$125.89	$389.05
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $208.93 / $309.03 / $309.03	Facility	26	$208.93	$309.03	$309.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $199.53 / $1,348.96	Professional		$97.72	$199.53	$1,348.96
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $79.43 / $501.19	Professional	26	$63.10	$79.43	$501.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $213.80 / $1,023.29	Professional		$190.55	$213.80	$1,023.29
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $158.49 / $245.47	Professional	26	$134.90	$158.49	$245.47
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $234.42 / $245.47	Professional		$177.83	$234.42	$245.47
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $169.82 / $177.83	Professional	26	$128.82	$169.82	$177.83
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $208.93 / $549.54	Professional		$173.78	$208.93	$549.54
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $128.82 / $269.15	Professional		$95.50	$128.82	$269.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $79.43 / $173.78	Professional	26	$67.61	$79.43	$173.78
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $199.53	Professional		$169.82	$169.82	$199.53
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $120.23 / $141.25	Professional	26	$120.23	$120.23	$141.25