Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.09 / $105.29 / $229.90	Professional		$61.09	$105.29	$229.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.58 / $193.80 / $287.29	Professional		$128.58	$193.80	$287.29
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $67.34 / $135.59 / $236.25	Professional		$67.34	$135.59	$236.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $103.74 / $175.37 / $392.86	Facility		$103.74	$175.37	$392.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $101.05 / $181.90 / $669.13	Professional		$101.05	$181.90	$669.13
Midlands Facility/Professional Facility Modifier Low / Median / High Price $103.74 / $165.91 / $248.60	Facility		$103.74	$165.91	$248.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $133.00 / $180.72 / $252.26	Professional		$133.00	$180.72	$252.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $68.26 / $122.43 / $186.18	Professional		$68.26	$122.43	$186.18
United Facility/Professional Facility Modifier Low / Median / High Price $1,204.00 / $1,640.00 / $2,126.00	Facility		$1,204.00	$1,640.00	$2,126.00
United Facility/Professional Professional Modifier Low / Median / High Price $92.43 / $140.85 / $262.33	Professional		$92.43	$140.85	$262.33
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $132.80 / $156.30 / $227.30	Professional		$132.80	$156.30	$227.30