Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $123.03 / $251.19	Professional		$93.33	$123.03	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $245.47 / $309.03	Professional		$107.15	$245.47	$309.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $177.83 / $549.54	Professional		$102.33	$177.83	$549.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $194.98 / $891.25	Professional		$114.82	$194.98	$891.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $257.04 / $281.84	Professional		$177.83	$257.04	$281.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $194.98 / $281.84	Professional		$190.55	$194.98	$281.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $199.53 / $263.03	Professional		$190.55	$199.53	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $154.88 / $295.12	Professional		$107.15	$154.88	$295.12
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $213.80 / $251.19	Professional		$169.82	$213.80	$251.19