Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.68 / $130.25 / $200.72	Professional		$42.68	$130.25	$200.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.05 / $285.24 / $413.08	Professional		$102.05	$285.24	$413.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $113.67 / $175.42 / $282.35	Professional		$113.67	$175.42	$282.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $160.96 / $289.20 / $1,004.88	Professional		$160.96	$289.20	$1,004.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $192.00 / $279.95 / $383.12	Professional		$192.00	$279.95	$383.12
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $22.97 / $124.54 / $231.52	Professional		$22.97	$124.54	$231.52
United Facility/Professional Professional Modifier Low / Median / High Price $153.66 / $201.20 / $402.01	Professional		$153.66	$201.20	$402.01
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $192.29 / $243.40 / $286.39	Professional		$192.29	$243.40	$286.39