Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $236.09 / $334.61 / $477.73	Professional		$236.09	$334.61	$477.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $451.96 / $523.98 / $616.11	Professional		$451.96	$523.98	$616.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $315.75 / $647.48	Professional		$150.00	$315.75	$647.48
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.73 / $118.54 / $215.87	Professional	26	$69.73	$118.54	$215.87
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $339.11 / $339.11 / $339.11	Facility	26	$339.11	$339.11	$339.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $269.57 / $483.10 / $1,687.36	Professional		$269.57	$483.10	$1,687.36
Midlands Facility/Professional Professional Modifier Low / Median / High Price $339.34 / $458.23 / $616.11	Professional		$339.34	$458.23	$616.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.00 / $350.40 / $622.60	Professional		$3.00	$350.40	$622.60
United Facility/Professional Professional Modifier Low / Median / High Price $240.19 / $465.33 / $651.58	Professional		$240.19	$465.33	$651.58
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $398.50 / $398.50 / $468.90	Professional		$398.50	$398.50	$468.90