Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.34 / $96.75 / $120.94	Professional		$73.34	$96.75	$120.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.70 / $169.59 / $211.99	Professional		$76.70	$169.59	$211.99
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $59.15 / $93.64 / $726.60	Professional		$59.15	$93.64	$726.60
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.95 / $28.92 / $162.88	Professional	26	$17.95	$28.92	$162.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $171.60 / $554.82	Professional		$60.00	$171.60	$554.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $156.05 / $200.01	Professional		$60.00	$156.05	$200.01
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $19.82 / $79.66 / $144.01	Professional		$19.82	$79.66	$144.01
United Facility/Professional Professional Modifier Low / Median / High Price $87.03 / $144.24 / $223.69	Professional		$87.03	$144.24	$223.69
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $126.48 / $160.10 / $188.40	Professional		$126.48	$160.10	$188.40