Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.61 / $194.91 / $672.00	Professional		$119.61	$194.91	$672.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $274.45 / $349.07 / $436.33	Professional		$274.45	$349.07	$436.33
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $127.84 / $202.77 / $361.19	Professional		$127.84	$202.77	$361.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $124.73 / $197.00 / $522.29	Professional		$124.73	$197.00	$522.29
Midlands Facility/Professional Professional Modifier Low / Median / High Price $210.50 / $268.98 / $372.31	Professional		$210.50	$268.98	$372.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $135.54 / $154.06 / $277.00	Professional		$135.54	$154.06	$277.00
United Facility/Professional Professional Modifier Low / Median / High Price $124.28 / $147.12 / $229.71	Professional		$124.28	$147.12	$229.71
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $219.07 / $277.30 / $326.30	Professional		$219.07	$277.30	$326.30