Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.66 / $163.25 / $302.25	Facility	26	$88.66	$163.25	$302.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $300.74 / $634.90 / $2,731.34	Professional		$300.74	$634.90	$2,731.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $164.40 / $169.33 / $174.26	Facility	26	$164.40	$169.33	$174.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $855.85 / $1,055.73 / $1,319.66	Professional		$855.85	$1,055.73	$1,319.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $382.67 / $511.23 / $797.46	Professional		$382.67	$511.23	$797.46
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.45 / $85.50 / $124.49	Professional	26	$52.45	$85.50	$124.49
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $169.33 / $169.33 / $169.33	Facility	26	$169.33	$169.33	$169.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $371.99 / $613.60 / $1,412.82	Professional		$371.99	$613.60	$1,412.82
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $169.33 / $174.26 / $316.80	Facility	26	$169.33	$174.26	$316.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $499.00 / $855.85 / $1,186.58	Professional		$499.00	$855.85	$1,186.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $56.89 / $400.58 / $743.06	Professional		$56.89	$400.58	$743.06
United Facility/Professional Professional Modifier Low / Median / High Price $371.99 / $519.29 / $835.20	Professional		$371.99	$519.29	$835.20
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $649.46 / $822.10 / $967.20	Professional		$649.46	$822.10	$967.20