Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $74.13 / $389.05	Facility	26	$74.13	$74.13	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $524.81 / $1,023.29	Professional		$398.11	$524.81	$1,023.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $114.82 / $436.52	Professional	26	$67.61	$114.82	$436.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $223.87 / $234.42 / $239.88	Facility	26	$223.87	$234.42	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,047.13 / $1,258.93	Professional		$1,000.00	$1,047.13	$1,258.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $165.96 / $169.82 / $204.17	Professional	26	$165.96	$169.82	$204.17
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $676.08 / $1,122.02	Professional		$363.08	$676.08	$1,122.02
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $107.15 / $173.78	Professional	26	$72.44	$107.15	$173.78
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $234.42 / $660.69 / $660.69	Facility	26	$234.42	$660.69	$660.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $776.25 / $2,754.23	Professional		$407.38	$776.25	$2,754.23
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $107.15 / $436.52	Professional	26	$69.18	$107.15	$436.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,000.00 / $1,737.80	Professional		$831.76	$1,000.00	$1,737.80
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $165.96 / $275.42	Professional	26	$141.25	$165.96	$275.42
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $239.88 / $239.88 / $239.88	Facility	26	$239.88	$239.88	$239.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,230.27 / $1,318.26	Professional		$776.25	$1,230.27	$1,318.26
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $186.21 / $213.80	Professional	26	$144.54	$186.21	$213.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $870.96 / $1,174.90	Professional		$794.33	$870.96	$1,174.90
United Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $645.65 / $1,348.96	Professional		$398.11	$645.65	$1,348.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $107.15 / $218.78	Professional	26	$72.44	$107.15	$218.78
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $933.25 / $1,096.48	Professional		$933.25	$933.25	$1,096.48
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $154.88 / $181.97	Professional	26	$154.88	$154.88	$181.97