Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.34 / $65.75 / $150.12	Professional		$45.34	$65.75	$150.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.29 / $106.78 / $133.47	Professional		$54.29	$106.78	$133.47
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $46.75 / $73.20 / $184.48	Professional		$46.75	$73.20	$184.48
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.79 / $21.09 / $47.44	Professional	26	$13.79	$21.09	$47.44
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $33.53 / $100.00 / $100.00	Facility	26	$33.53	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $57.70 / $104.22 / $500.00	Professional		$57.70	$104.22	$500.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $70.16 / $107.53 / $128.51	Professional		$70.16	$107.53	$128.51
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $51.44 / $91.82	Professional		$15.14	$51.44	$91.82
United Facility/Professional Professional Modifier Low / Median / High Price $54.05 / $78.62 / $132.19	Professional		$54.05	$78.62	$132.19
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $75.68 / $95.80 / $112.70	Professional		$75.68	$95.80	$112.70