Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $79.43 / $79.43	Professional		$63.10	$79.43	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $39.81 / $48.98	Professional		$26.30	$39.81	$48.98
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $177.83 / $194.98	Professional		$114.82	$177.83	$194.98
Medica Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $85.11 / $107.15	Facility		$79.43	$85.11	$107.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $234.42 / $275.42	Professional		$204.17	$234.42	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $60.26 / $125.89	Professional		$19.95	$60.26	$125.89
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $72.44	Professional		$72.44	$72.44	$72.44