Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $131.83 / $346.74	Professional		$87.10	$131.83	$346.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $288.40 / $416.87	Professional		$229.09	$288.40	$416.87
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $199.53 / $331.13	Professional		$100.00	$199.53	$331.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $251.19 / $724.44	Professional		$144.54	$251.19	$724.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $257.04 / $371.54	Professional		$213.80	$257.04	$371.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $251.19 / $354.81	Professional		$177.83	$251.19	$354.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.02 / $263.03 / $354.81	Professional		$3.02	$263.03	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $177.83 / $323.59	Professional		$107.15	$177.83	$323.59
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $218.78 / $309.03	Professional		$186.21	$218.78	$309.03