Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $261.56 / $290.31 / $1,503.01	Professional		$261.56	$290.31	$1,503.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $420.20 / $631.24 / $810.31	Professional		$420.20	$631.24	$810.31
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $256.64 / $403.00 / $781.92	Professional		$256.64	$403.00	$781.92
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $216.43 / $339.18 / $603.59	Professional	26	$216.43	$339.18	$603.59
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $546.99 / $1,083.21 / $1,083.21	Facility	26	$546.99	$1,083.21	$1,083.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $341.49 / $623.67 / $3,530.08	Professional		$341.49	$623.67	$3,530.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $412.80 / $625.00 / $764.00	Professional		$412.80	$625.00	$764.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $46.32 / $239.17 / $496.27	Professional		$46.32	$239.17	$496.27
United Facility/Professional Professional Modifier Low / Median / High Price $304.25 / $523.50 / $752.33	Professional		$304.25	$523.50	$752.33
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $438.06 / $554.50 / $652.29	Professional		$438.06	$554.50	$652.29