Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.29 / $123.12 / $258.52	Professional		$80.29	$123.12	$258.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.00 / $218.44 / $273.05	Professional		$116.00	$218.44	$273.05
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $91.43 / $122.26 / $308.06	Professional		$91.43	$122.26	$308.06
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.08 / $60.57 / $124.93	Professional	26	$38.08	$60.57	$124.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $101.00 / $216.25 / $706.46	Professional		$101.00	$216.25	$706.46
Midlands Facility/Professional Professional Modifier Low / Median / High Price $113.69 / $203.04 / $258.16	Professional		$113.69	$203.04	$258.16
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.58 / $98.84 / $185.84	Professional		$41.58	$98.84	$185.84
United Facility/Professional Professional Modifier Low / Median / High Price $111.50 / $195.45 / $275.92	Professional		$111.50	$195.45	$275.92
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $163.93 / $207.50 / $244.10	Professional		$163.93	$207.50	$244.10