Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.26 / $125.73 / $182.10	Professional		$78.26	$125.73	$182.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.07 / $243.47 / $365.20	Professional		$165.07	$243.47	$365.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $85.53 / $175.29 / $327.77	Professional		$85.53	$175.29	$327.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $122.68 / $228.33 / $854.69	Professional		$122.68	$228.33	$854.69
Midlands Facility/Professional Professional Modifier Low / Median / High Price $168.48 / $228.33 / $307.97	Professional		$168.48	$228.33	$307.97
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $88.25 / $158.08 / $242.26	Professional		$88.25	$158.08	$242.26
United Facility/Professional Professional Modifier Low / Median / High Price $113.38 / $185.17 / $317.91	Professional		$113.38	$185.17	$317.91
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $169.40 / $199.30 / $291.39	Professional		$169.40	$199.30	$291.39