Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $152.88 / $213.24 / $264.70	Professional		$152.88	$213.24	$264.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $235.71 / $500.39 / $937.72	Professional		$235.71	$500.39	$937.72
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $204.12 / $318.52 / $518.11	Professional		$204.12	$318.52	$518.11
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $42.70 / $71.75 / $126.51	Professional	26	$42.70	$71.75	$126.51
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $233.70 / $233.70 / $233.70	Facility	26	$233.70	$233.70	$233.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $217.38 / $400.96 / $1,494.48	Professional		$217.38	$400.96	$1,494.48
Midlands Facility/Professional Professional Modifier Low / Median / High Price $303.80 / $441.13 / $510.30	Professional		$303.80	$441.13	$510.30
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $318.30 / $318.30 / $694.00	Professional		$318.30	$318.30	$694.00
United Facility/Professional Professional Modifier Low / Median / High Price $205.35 / $274.85 / $511.06	Professional		$205.35	$274.85	$511.06
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $344.68 / $436.30 / $513.29	Professional		$344.68	$436.30	$513.29