Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.89 / $62.79 / $150.18	Professional		$42.89	$62.79	$150.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.47 / $104.81 / $143.72	Professional		$55.47	$104.81	$143.72
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $44.78 / $77.20 / $301.72	Professional		$44.78	$77.20	$301.72
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $14.32 / $52.18	Professional	26	$9.11	$14.32	$52.18
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $24.96 / $169.20 / $169.20	Facility	26	$24.96	$169.20	$169.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $62.85 / $110.72 / $619.00	Professional		$62.85	$110.72	$619.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $78.75 / $110.54 / $139.66	Professional		$78.75	$110.54	$139.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.06 / $47.72 / $86.59	Professional		$10.06	$47.72	$86.59
United Facility/Professional Professional Modifier Low / Median / High Price $54.01 / $83.91 / $132.08	Professional		$54.01	$83.91	$132.08
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $71.73 / $90.80 / $106.80	Professional		$71.73	$90.80	$106.80