Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $359.34 / $456.86 / $545.94	Professional		$359.34	$456.86	$545.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $449.00 / $881.30 / $1,063.61	Professional		$449.00	$881.30	$1,063.61
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $336.48 / $454.22 / $675.25	Professional		$336.48	$454.22	$675.25
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.93 / $166.70 / $227.43	Professional	26	$102.93	$166.70	$227.43
Medica Facility/Professional Professional Modifier Low / Median / High Price $401.00 / $867.49 / $2,594.32	Professional		$401.00	$867.49	$2,594.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $449.00 / $781.12 / $989.22	Professional		$449.00	$781.12	$989.22
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $109.91 / $353.60 / $688.46	Professional		$109.91	$353.60	$688.46
United Facility/Professional Professional Modifier Low / Median / High Price $402.94 / $731.15 / $996.36	Professional		$402.94	$731.15	$996.36
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $606.72 / $768.00 / $903.50	Professional		$606.72	$768.00	$903.50