Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.86 / $205.78 / $279.49	Professional		$109.86	$205.78	$279.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.43 / $325.22 / $422.37	Professional		$161.43	$325.22	$422.37
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $132.71 / $178.79 / $437.20	Professional		$132.71	$178.79	$437.20
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.16 / $41.24 / $88.55	Professional	26	$25.16	$41.24	$88.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $143.26 / $300.58 / $1,185.08	Professional		$143.26	$300.58	$1,185.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $159.61 / $306.14 / $422.37	Professional		$159.61	$306.14	$422.37
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $27.71 / $139.71 / $272.02	Professional		$27.71	$139.71	$272.02
United Facility/Professional Professional Modifier Low / Median / High Price $143.26 / $273.50 / $379.96	Professional		$143.26	$273.50	$379.96
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $242.45 / $306.89 / $361.10	Professional		$242.45	$306.89	$361.10