Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.84 / $280.89 / $453.87	Facility	26	$147.84	$280.89	$453.87
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $74.98 / $90.59 / $227.13	Facility	53	$74.98	$90.59	$227.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $227.52 / $330.43 / $453.00	Professional		$227.52	$330.43	$453.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.06 / $125.24 / $528.08	Professional	26	$99.06	$125.24	$528.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $319.60 / $577.04 / $917.23	Professional		$319.60	$577.04	$917.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $134.33 / $262.05 / $393.84	Professional	26	$134.33	$262.05	$393.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $206.99 / $346.10 / $972.43	Professional		$206.99	$346.10	$972.43
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.74 / $161.01 / $340.86	Professional	26	$97.74	$161.01	$340.86
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $985.36 / $985.36 / $985.36	Facility	26	$985.36	$985.36	$985.36
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $228.96 / $228.96 / $228.96	Facility	53	$228.96	$228.96	$228.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $256.99 / $513.76 / $1,920.39	Professional		$256.99	$513.76	$1,920.39
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $115.39 / $191.27 / $1,030.27	Professional	26	$115.39	$191.27	$1,030.27
Midlands Facility/Professional Professional Modifier Low / Median / High Price $364.74 / $564.45 / $655.74	Professional		$364.74	$564.45	$655.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $105.34 / $213.68 / $415.32	Professional		$105.34	$213.68	$415.32
United Facility/Professional Professional Modifier Low / Median / High Price $245.31 / $390.52 / $728.48	Professional		$245.31	$390.52	$728.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $112.60 / $165.77 / $307.52	Professional	26	$112.60	$165.77	$307.52
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $367.43 / $465.10 / $547.10	Professional		$367.43	$465.10	$547.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $164.48 / $208.20 / $244.90	Professional	26	$164.48	$208.20	$244.90