Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.75 / $87.42 / $333.98	Professional		$62.75	$87.42	$333.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.59 / $155.82 / $224.97	Professional		$112.59	$155.82	$224.97
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $54.45 / $109.23 / $237.01	Professional		$54.45	$109.23	$237.01
Medica Facility/Professional Facility Modifier Low / Median / High Price $85.85 / $164.44 / $661.20	Facility		$85.85	$164.44	$661.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $86.16 / $155.81 / $569.67	Professional		$86.16	$155.81	$569.67
Midlands Facility/Professional Facility Modifier Low / Median / High Price $75.64 / $142.61 / $207.87	Facility		$75.64	$142.61	$207.87
Midlands Facility/Professional Professional Modifier Low / Median / High Price $115.15 / $156.00 / $207.87	Professional		$115.15	$156.00	$207.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $53.92 / $95.99 / $142.63	Professional		$53.92	$95.99	$142.63
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 $75.39 / $114.93 / $233.73	Professional		$75.39	$114.93	$233.73
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $105.90 / $124.60 / $176.70	Professional		$105.90	$124.60	$176.70