Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $246.86 / $246.86 / $246.86	Facility	26	$246.86	$246.86	$246.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $561.28 / $870.24 / $2,500.00	Professional		$561.28	$870.24	$2,500.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $185.90 / $298.17 / $702.40	Professional	26	$185.90	$298.17	$702.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $591.60 / $609.35 / $627.10	Facility	26	$591.60	$609.35	$627.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,183.84 / $1,437.37 / $1,796.72	Professional		$1,183.84	$1,437.37	$1,796.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $400.41 / $464.64 / $580.80	Professional	26	$400.41	$464.64	$580.80
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $603.98 / $835.47 / $2,560.71	Professional		$603.98	$835.47	$2,560.71
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $206.54 / $287.58 / $795.00	Professional	26	$206.54	$287.58	$795.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $609.35 / $609.35 / $609.35	Facility	26	$609.35	$609.35	$609.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $620.84 / $846.60 / $2,117.73	Professional		$620.84	$846.60	$2,117.73
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $216.78 / $256.62 / $1,013.18	Professional	26	$216.78	$256.62	$1,013.18
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $609.35 / $627.10 / $1,112.82	Facility	26	$609.35	$627.10	$1,112.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,021.63 / $1,255.84 / $2,079.73	Professional		$1,021.63	$1,255.84	$2,079.73
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $202.68 / $564.84 / $1,008.24	Professional		$202.68	$564.84	$1,008.24
United Facility/Professional Professional Modifier Low / Median / High Price $620.84 / $734.96 / $1,123.73	Professional		$620.84	$734.96	$1,123.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $216.78 / $256.62 / $380.35	Professional	26	$216.78	$256.62	$380.35
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $894.36 / $1,132.09 / $1,331.80	Professional		$894.36	$1,132.09	$1,331.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $294.51 / $372.80 / $438.60	Professional	26	$294.51	$372.80	$438.60