Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.78 / $121.35 / $348.00	Professional		$47.78	$121.35	$348.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $130.72 / $214.09 / $267.62	Professional		$130.72	$214.09	$267.62
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $77.81 / $132.65 / $251.71	Professional		$77.81	$132.65	$251.71
Medica Facility/Professional Professional Modifier Low / Median / High Price $79.86 / $133.28 / $404.10	Professional		$79.86	$133.28	$404.10
Midlands Facility/Professional Professional Modifier Low / Median / High Price $107.00 / $169.25 / $231.79	Professional		$107.00	$169.25	$231.79
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $83.14 / $145.66 / $167.84	Professional		$83.14	$145.66	$167.84
United Facility/Professional Professional Modifier Low / Median / High Price $78.45 / $97.03 / $147.69	Professional		$78.45	$97.03	$147.69
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $133.43 / $168.90 / $198.70	Professional		$133.43	$168.90	$198.70