Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $322.41 / $924.93 / $2,767.15	Facility	26	$322.41	$924.93	$2,767.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,260.18 / $1,558.08 / $3,066.53	Professional		$1,260.18	$1,558.08	$3,066.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $363.17 / $486.81 / $1,470.08	Professional	26	$363.17	$486.81	$1,470.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,461.48 / $2,922.92 / $3,342.35	Professional		$2,461.48	$2,922.92	$3,342.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $699.99 / $867.41 / $975.21	Professional	26	$699.99	$867.41	$975.21
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,038.63 / $1,583.09 / $5,655.92	Professional		$1,038.63	$1,583.09	$5,655.92
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $339.30 / $520.61 / $1,521.56	Professional	26	$339.30	$520.61	$1,521.56
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $3,363.92 / $3,363.92 / $3,363.92	Facility	26	$3,363.92	$3,363.92	$3,363.92
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,439.18 / $2,765.30 / $4,584.04	Professional		$1,439.18	$2,765.30	$4,584.04
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $427.60 / $839.33 / $2,275.66	Professional	26	$427.60	$839.33	$2,275.66
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,730.07 / $2,711.18 / $3,342.35	Professional		$1,730.07	$2,711.18	$3,342.35
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $402.28 / $1,217.76 / $2,373.16	Professional		$402.28	$1,217.76	$2,373.16
United Facility/Professional Professional Modifier Low / Median / High Price $1,379.22 / $2,602.53 / $3,704.29	Professional		$1,379.22	$2,602.53	$3,704.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $409.78 / $760.03 / $1,011.98	Professional	26	$409.78	$760.03	$1,011.98
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,874.43 / $2,372.69 / $2,791.50	Professional		$1,874.43	$2,372.69	$2,791.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $575.12 / $728.00 / $856.40	Professional	26	$575.12	$728.00	$856.40