Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.22 / $152.88 / $579.00	Professional		$99.22	$152.88	$579.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $152.00 / $251.61 / $314.29	Professional		$152.00	$251.61	$314.29
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $97.78 / $147.80 / $266.05	Professional		$97.78	$147.80	$266.05
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.13 / $74.94 / $124.70	Professional	26	$46.13	$74.94	$124.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $124.82 / $252.71 / $803.29	Professional		$124.82	$252.71	$803.29
Midlands Facility/Professional Professional Modifier Low / Median / High Price $143.74 / $229.81 / $314.29	Professional		$143.74	$229.81	$314.29
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $51.30 / $99.72 / $199.47	Professional		$51.30	$99.72	$199.47
United Facility/Professional Professional Modifier Low / Median / High Price $121.89 / $226.76 / $305.23	Professional		$121.89	$226.76	$305.23
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $174.51 / $220.90 / $259.80	Professional		$174.51	$220.90	$259.80