Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $245.47 / $245.47 / $363.08	Facility	26	$245.47	$245.47	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,230.27 / $2,398.83	Professional		$933.25	$1,230.27	$2,398.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $2,398.83 / $2,570.40	Professional		$2,041.74	$2,398.83	$2,570.40
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,288.25 / $2,398.83	Professional		$831.76	$1,288.25	$2,398.83
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $251.19 / $398.11 / $977.24	Professional	26	$251.19	$398.11	$977.24
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $2,511.89 / $2,511.89 / $2,511.89	Facility	26	$2,511.89	$2,511.89	$2,511.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,905.46 / $3,630.78	Professional		$1,148.15	$1,905.46	$3,630.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $2,398.83 / $3,715.35	Professional		$2,238.72	$2,398.83	$3,715.35
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $630.96 / $645.65 / $1,122.02	Professional	26	$630.96	$645.65	$1,122.02
Midlands Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $2,089.30 / $2,691.53	Professional		$2,089.30	$2,089.30	$2,691.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $933.25 / $1,995.26	Professional		$316.23	$933.25	$1,995.26
United Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,513.56 / $3,019.95	Professional		$1,122.02	$1,513.56	$3,019.95
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,905.46 / $2,290.87	Professional		$1,513.56	$1,905.46	$2,290.87