Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.95 / $88.79 / $123.71	Professional		$68.95	$88.79	$123.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $129.15 / $248.91	Professional		$70.00	$129.15	$248.91
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $73.73 / $115.52 / $217.67	Professional		$73.73	$115.52	$217.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $137.80 / $250.58 / $660.93	Professional		$137.80	$250.58	$660.93
Midlands Facility/Professional Professional Modifier Low / Median / High Price $147.66 / $184.46 / $259.62	Professional		$147.66	$184.46	$259.62
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $130.19 / $130.19 / $248.80	Professional		$130.19	$130.19	$248.80
United Facility/Professional Professional Modifier Low / Median / High Price $122.59 / $198.28 / $289.95	Professional		$122.59	$198.28	$289.95
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $92.10 / $111.30 / $144.50	Professional		$92.10	$111.30	$144.50