Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $75.86 / $199.53	Professional		$52.48	$75.86	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $177.83 / $208.93	Professional		$97.72	$177.83	$208.93
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $117.49 / $169.82	Professional		$77.62	$117.49	$169.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $131.83 / $776.25	Professional		$61.66	$131.83	$776.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $177.83 / $194.98	Professional		$177.83	$177.83	$194.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $134.90 / $173.78	Professional		$74.13	$134.90	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $67.61 / $190.55	Professional		$61.66	$67.61	$190.55
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $162.18 / $162.18	Professional		$138.04	$162.18	$162.18