Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $245.47 / $295.12 / $295.12	Facility	26	$245.47	$295.12	$295.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $630.96 / $1,584.89	Professional		$489.78	$630.96	$1,584.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $208.93 / $707.95	Professional	26	$169.82	$208.93	$707.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $588.84 / $602.56 / $630.96	Facility	26	$588.84	$602.56	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,479.11 / $1,819.70	Professional		$1,318.26	$1,479.11	$1,819.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $426.58 / $478.63 / $588.84	Professional	26	$426.58	$478.63	$588.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $912.01 / $2,570.40	Professional		$602.56	$912.01	$2,570.40
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $251.19 / $288.40 / $812.83	Professional	26	$251.19	$288.40	$812.83
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $602.56 / $602.56 / $912.01	Facility	26	$602.56	$602.56	$912.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $933.25 / $2,089.30	Professional		$645.65	$933.25	$2,089.30
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $213.80 / $257.04 / $812.83	Professional	26	$213.80	$257.04	$812.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,318.26 / $2,187.76	Professional		$1,122.02	$1,318.26	$2,187.76
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $380.19 / $426.58 / $741.31	Professional	26	$380.19	$426.58	$741.31
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $630.96 / $630.96 / $630.96	Facility	26	$630.96	$630.96	$630.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,445.44 / $1,621.81	Professional		$1,445.44	$1,445.44	$1,621.81
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $478.63 / $478.63 / $537.03	Professional	26	$478.63	$478.63	$537.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $446.68 / $1,023.29	Professional		$204.17	$446.68	$1,023.29
United Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $741.31 / $1,288.25	Professional		$616.60	$741.31	$1,288.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $218.78 / $257.04 / $446.68	Professional	26	$218.78	$257.04	$446.68
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,122.02 / $1,318.26	Professional		$891.25	$1,122.02	$1,318.26
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $295.12 / $371.54 / $436.52	Professional	26	$295.12	$371.54	$436.52