Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $350.45 / $350.45 / $350.45	Facility	26	$350.45	$350.45	$350.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $835.03 / $1,294.51 / $4,073.60	Professional		$835.03	$1,294.51	$4,073.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $839.96 / $865.16 / $890.36	Facility	26	$839.96	$865.16	$890.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,765.76 / $2,150.23 / $2,687.80	Professional		$1,765.76	$2,150.23	$2,687.80
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $902.12 / $1,246.58 / $3,905.68	Professional		$902.12	$1,246.58	$3,905.68
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $291.39 / $405.51 / $1,138.49	Professional	26	$291.39	$405.51	$1,138.49
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $865.16 / $865.16 / $865.16	Facility	26	$865.16	$865.16	$865.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $934.13 / $1,273.82 / $3,229.95	Professional		$934.13	$1,273.82	$3,229.95
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $865.16 / $890.36 / $1,571.88	Facility	26	$865.16	$890.36	$1,571.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,545.84 / $1,916.15 / $3,107.69	Professional		$1,545.84	$1,916.15	$3,107.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $285.61 / $766.96 / $1,508.86	Professional		$285.61	$766.96	$1,508.86
United Facility/Professional Professional Modifier Low / Median / High Price $934.13 / $1,098.18 / $1,670.34	Professional		$934.13	$1,098.18	$1,670.34
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,336.36 / $1,691.60 / $1,990.10	Professional		$1,336.36	$1,691.60	$1,990.10