Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.01 / $58.90 / $65.67	Professional		$50.01	$58.90	$65.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.11 / $110.26 / $193.21	Professional		$34.11	$110.26	$193.21
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $42.54 / $101.06 / $146.51	Professional		$42.54	$101.06	$146.51
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $34.14 / $79.27	Professional	26	$19.05	$34.14	$79.27
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $113.52 / $113.52 / $113.52	Facility	26	$113.52	$113.52	$113.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $60.80 / $110.26 / $425.20	Professional		$60.80	$110.26	$425.20
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $49.60 / $49.60 / $49.60	Facility	26	$49.60	$49.60	$49.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $79.16 / $120.12 / $174.84	Professional		$79.16	$120.12	$174.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $19.98 / $64.34 / $118.32	Professional		$19.98	$64.34	$118.32
United Facility/Professional Professional Modifier Low / Median / High Price $60.80 / $64.95 / $147.46	Professional		$60.80	$64.95	$147.46
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $120.90 / $142.19 / $167.20	Professional		$120.90	$142.19	$167.20