Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.03 / $139.54 / $192.28	Professional		$107.03	$139.54	$192.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.00 / $294.24 / $337.20	Professional		$161.00	$294.24	$337.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $111.13 / $162.62 / $3,370.05	Professional		$111.13	$162.62	$3,370.05
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.09 / $90.65 / $1,541.84	Professional	26	$56.09	$90.65	$1,541.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $142.00 / $298.49 / $1,240.15	Professional		$142.00	$298.49	$1,240.15
Midlands Facility/Professional Professional Modifier Low / Median / High Price $158.13 / $267.29 / $337.20	Professional		$158.13	$267.29	$337.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $60.45 / $112.71 / $223.40	Professional		$60.45	$112.71	$223.40
United Facility/Professional Professional Modifier Low / Median / High Price $143.99 / $271.58 / $360.06	Professional		$143.99	$271.58	$360.06
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $197.66 / $250.20 / $294.39	Professional		$197.66	$250.20	$294.39