Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.47 / $69.45 / $146.22	Professional		$52.47	$69.45	$146.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.63 / $171.89 / $207.89	Professional		$84.63	$171.89	$207.89
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $66.42 / $118.03 / $170.51	Professional		$66.42	$118.03	$170.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $61.52 / $122.20 / $779.19	Professional		$61.52	$122.20	$779.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $89.26 / $118.17 / $166.06	Professional		$89.26	$118.17	$166.06
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $70.31 / $125.52 / $146.79	Professional		$70.31	$125.52	$146.79
United Facility/Professional Professional Modifier Low / Median / High Price $61.52 / $63.37 / $166.41	Professional		$61.52	$63.37	$166.41
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $138.69 / $163.19 / $163.19	Professional		$138.69	$163.19	$163.19