Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.90 / $173.20 / $371.67	Professional		$137.90	$173.20	$371.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $189.46 / $307.08 / $399.93	Professional		$189.46	$307.08	$399.93
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $132.10 / $192.73 / $374.96	Professional		$132.10	$192.73	$374.96
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $78.75 / $121.16 / $224.55	Professional	26	$78.75	$121.16	$224.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $188.18 / $320.36 / $956.27	Professional		$188.18	$320.36	$956.27
Midlands Facility/Professional Professional Modifier Low / Median / High Price $184.24 / $279.64 / $399.93	Professional		$184.24	$279.64	$399.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $64.06 / $138.34 / $265.68	Professional		$64.06	$138.34	$265.68
United Facility/Professional Professional Modifier Low / Median / High Price $172.00 / $294.87 / $429.99	Professional		$172.00	$294.87	$429.99
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $232.50 / $294.30 / $346.20	Professional		$232.50	$294.30	$346.20