Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.89 / $88.35 / $452.63	Professional		$73.89	$88.35	$452.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.27 / $170.29 / $222.19	Professional		$96.27	$170.29	$222.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $78.31 / $116.15 / $313.20	Professional		$78.31	$116.15	$313.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $93.10 / $181.68 / $289.61	Facility		$93.10	$181.68	$289.61
Medica Facility/Professional Professional Modifier Low / Median / High Price $102.10 / $175.29 / $533.04	Professional		$102.10	$175.29	$533.04
Midlands Facility/Professional Facility Modifier Low / Median / High Price $126.00 / $195.17 / $214.62	Facility		$126.00	$195.17	$214.62
Midlands Facility/Professional Professional Modifier Low / Median / High Price $126.00 / $184.87 / $222.19	Professional		$126.00	$184.87	$222.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $73.92 / $133.61 / $165.30	Professional		$73.92	$133.61	$165.30
United Facility/Professional Professional Modifier Low / Median / High Price $90.76 / $138.25 / $227.25	Professional		$90.76	$138.25	$227.25
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $124.98 / $158.19 / $186.20	Professional		$124.98	$158.19	$186.20