Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.38 / $121.39 / $182.00	Professional		$91.38	$121.39	$182.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.67 / $148.61 / $247.03	Professional		$80.67	$148.61	$247.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $68.94 / $94.79 / $181.53	Professional		$68.94	$94.79	$181.53
Medica Facility/Professional Facility Modifier Low / Median / High Price $88.71 / $185.79 / $311.32	Facility		$88.71	$185.79	$311.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $118.35 / $173.81 / $595.01	Professional		$118.35	$173.81	$595.01
Midlands Facility/Professional Facility Modifier Low / Median / High Price $160.80 / $221.02 / $311.32	Facility		$160.80	$221.02	$311.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $175.35 / $221.02 / $311.32	Professional		$175.35	$221.02	$311.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $77.52 / $138.37 / $219.80	Professional		$77.52	$138.37	$219.80
United Facility/Professional Professional Modifier Low / Median / High Price $111.04 / $137.16 / $263.25	Professional		$111.04	$137.16	$263.25
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $168.90 / $198.70 / $268.30	Professional		$168.90	$198.70	$268.30