Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $118.37 / $171.24 / $753.82	Professional		$118.37	$171.24	$753.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $184.44 / $257.02 / $361.17	Professional		$184.44	$257.02	$361.17
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $114.99 / $150.59 / $491.32	Professional		$114.99	$150.59	$491.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $140.04 / $250.42 / $903.71	Professional		$140.04	$250.42	$903.71
Midlands Facility/Professional Professional Modifier Low / Median / High Price $180.44 / $257.02 / $339.88	Professional		$180.44	$257.02	$339.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $105.03 / $187.48 / $234.94	Professional		$105.03	$187.48	$234.94
United Facility/Professional Professional Modifier Low / Median / High Price $136.99 / $203.70 / $336.94	Professional		$136.99	$203.70	$336.94
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $187.15 / $236.90 / $278.70	Professional		$187.15	$236.90	$278.70