Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $114.82 / $239.88	Professional		$77.62	$114.82	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $251.19 / $371.54	Professional		$151.36	$251.19	$371.54
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $154.88 / $354.81	Professional		$79.43	$154.88	$354.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $223.87 / $691.83	Professional		$120.23	$223.87	$691.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $257.04 / $309.03	Professional		$186.21	$257.04	$309.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $229.09 / $309.03	Professional		$165.96	$229.09	$309.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $158.49 / $288.40	Professional		$87.10	$158.49	$288.40
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $141.25 / $275.42	Professional		$85.11	$141.25	$275.42
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $199.53 / $288.40	Professional		$169.82	$199.53	$288.40