Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.09 / $70.43 / $152.93	Professional		$45.09	$70.43	$152.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.20 / $110.27 / $147.06	Professional		$62.20	$110.27	$147.06
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $49.14 / $77.22 / $183.54	Professional		$49.14	$77.22	$183.54
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.93 / $18.73 / $39.53	Professional	26	$11.93	$18.73	$39.53
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $28.91 / $169.20 / $169.20	Facility	26	$28.91	$169.20	$169.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $63.94 / $111.42 / $452.94	Professional		$63.94	$111.42	$452.94
Midlands Facility/Professional Professional Modifier Low / Median / High Price $83.15 / $112.40 / $141.15	Professional		$83.15	$112.40	$141.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $12.77 / $53.44 / $95.39	Professional		$12.77	$53.44	$95.39
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $84.92 / $134.37	Professional		$54.95	$84.92	$134.37
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $99.60 / $117.20	Professional		$78.68	$99.60	$117.20