Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $158.49 / $407.38	Professional		$134.90	$158.49	$407.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $389.05 / $478.63	Professional		$389.05	$389.05	$478.63
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $263.03 / $478.63	Professional		$151.36	$263.03	$478.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $338.84 / $891.25	Professional		$177.83	$338.84	$891.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $389.05 / $912.01	Professional		$323.59	$389.05	$912.01
Midlands Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $380.19 / $416.87	Professional		$380.19	$380.19	$416.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $123.03 / $275.42	Professional		$45.71	$123.03	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $218.78 / $426.58	Professional		$165.96	$218.78	$426.58
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $275.42 / $323.59	Professional		$218.78	$275.42	$323.59