Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.87 / $82.35 / $172.12	Professional		$74.87	$82.35	$172.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $110.00 / $180.30 / $219.36	Professional		$110.00	$180.30	$219.36
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $70.48 / $104.52 / $314.27	Professional		$70.48	$104.52	$314.27
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.48 / $45.26 / $124.92	Professional	26	$28.48	$45.26	$124.92
Medica Facility/Professional Professional Modifier Low / Median / High Price $89.18 / $179.30 / $655.00	Professional		$89.18	$179.30	$655.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $101.00 / $160.88 / $217.38	Professional		$101.00	$160.88	$217.38
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $31.84 / $73.95 / $143.91	Professional		$31.84	$73.95	$143.91
United Facility/Professional Professional Modifier Low / Median / High Price $85.31 / $146.94 / $208.61	Professional		$85.31	$146.94	$208.61
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $126.48 / $160.10 / $188.40	Professional		$126.48	$160.10	$188.40