Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $165.96 / $398.11	Professional		$87.10	$165.96	$398.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $239.88 / $489.78	Professional		$102.33	$239.88	$489.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $251.19 / $478.63	Professional		$87.10	$251.19	$478.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $302.00 / $1,318.26	Professional		$165.96	$302.00	$1,318.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $331.13 / $436.52	Professional		$208.93	$331.13	$436.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $281.84 / $489.78	Professional		$186.21	$281.84	$489.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $190.55 / $398.11	Professional		$89.13	$190.55	$398.11
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $190.55 / $380.19	Professional		$104.71	$190.55	$380.19
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $213.80 / $389.05	Professional		$173.78	$213.80	$389.05