Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.26 / $89.17 / $173.44	Professional		$58.26	$89.17	$173.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.63 / $109.31 / $278.92	Professional		$50.63	$109.31	$278.92
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $46.18 / $111.49 / $159.27	Professional		$46.18	$111.49	$159.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $110.04 / $144.79 / $452.96	Professional		$110.04	$144.79	$452.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $126.87 / $176.16 / $302.77	Professional		$126.87	$176.16	$302.77
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $49.86 / $111.49 / $217.34	Professional		$49.86	$111.49	$217.34
United Facility/Professional Professional Modifier Low / Median / High Price $108.33 / $129.60 / $236.56	Professional		$108.33	$129.60	$236.56
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $111.50 / $131.19 / $266.10	Professional		$111.50	$131.19	$266.10