Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.57 / $80.15 / $146.52	Professional		$61.57	$80.15	$146.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.92 / $140.97 / $176.22	Professional		$74.92	$140.97	$176.22
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $61.60 / $98.84 / $256.89	Professional		$61.60	$98.84	$256.89
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.62 / $27.47 / $63.25	Professional	26	$17.62	$27.47	$63.25
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $42.94 / $100.00 / $100.00	Facility	26	$42.94	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $79.18 / $142.61 / $714.00	Professional		$79.18	$142.61	$714.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $96.97 / $146.12 / $176.00	Professional		$96.97	$146.12	$176.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $19.79 / $68.26 / $121.84	Professional		$19.79	$68.26	$121.84
United Facility/Professional Professional Modifier Low / Median / High Price $74.00 / $107.63 / $178.04	Professional		$74.00	$107.63	$178.04
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $100.09 / $126.70 / $149.10	Professional		$100.09	$126.70	$149.10