Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.69 / $114.28 / $114.28	Professional		$66.69	$114.28	$114.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $155.75 / $185.10 / $198.67	Professional		$155.75	$185.10	$198.67
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $66.54 / $104.40 / $250.17	Professional		$66.54	$104.40	$250.17
Medica Facility/Professional Facility Modifier Low / Median / High Price $99.04 / $181.05 / $1,607.00	Facility		$99.04	$181.05	$1,607.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $91.51 / $171.65 / $660.00	Professional		$91.51	$171.65	$660.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $115.38 / $155.75 / $216.91	Facility		$115.38	$155.75	$216.91
Midlands Facility/Professional Professional Modifier Low / Median / High Price $116.00 / $155.75 / $216.91	Professional		$116.00	$155.75	$216.91
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $124.60 / $136.19 / $175.50	Professional		$124.60	$136.19	$175.50
United Facility/Professional Facility Modifier Low / Median / High Price $1,204.00 / $1,607.00 / $2,126.00	Facility		$1,204.00	$1,607.00	$2,126.00
United Facility/Professional Professional Modifier Low / Median / High Price $85.12 / $146.12 / $230.90	Professional		$85.12	$146.12	$230.90
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $158.69	Professional		$134.90	$134.90	$158.69