Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $117.49 / $389.05	Professional		$58.88	$117.49	$389.05
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $57.54 / $57.54 / $57.54	Professional	52	$57.54	$57.54	$57.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $162.18 / $218.78	Professional		$114.82	$162.18	$218.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $112.20 / $234.42	Professional		$67.61	$112.20	$234.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $151.36 / $1,412.54	Professional		$75.86	$151.36	$1,412.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $186.21 / $223.87	Professional		$138.04	$186.21	$223.87
Midlands Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $190.55	Professional		$151.36	$151.36	$190.55
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $75.86 / $151.36	Professional		$38.90	$75.86	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $123.03 / $204.17	Professional		$70.79	$123.03	$204.17
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $144.54 / $173.78	Professional		$114.82	$144.54	$173.78