Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.19 / $128.72 / $279.79	Professional		$115.19	$128.72	$279.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.21 / $217.84 / $321.79	Professional		$116.21	$217.84	$321.79
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $117.38 / $194.42 / $555.16	Professional		$117.38	$194.42	$555.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $131.85 / $220.71 / $314.91	Facility		$131.85	$220.71	$314.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $137.76 / $243.44 / $1,165.68	Professional		$137.76	$243.44	$1,165.68
Midlands Facility/Professional Facility Modifier Low / Median / High Price $184.00 / $261.54 / $307.35	Facility		$184.00	$261.54	$307.35
Midlands Facility/Professional Professional Modifier Low / Median / High Price $168.00 / $251.47 / $318.58	Professional		$168.00	$251.47	$318.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $110.50 / $199.33 / $238.53	Professional		$110.50	$199.33	$238.53
United Facility/Professional Professional Modifier Low / Median / High Price $127.76 / $191.64 / $322.14	Professional		$127.76	$191.64	$322.14
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $176.72 / $223.70 / $273.70	Professional		$176.72	$223.70	$273.70