Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.76 / $76.64 / $245.00	Professional		$57.76	$76.64	$245.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.33 / $160.90 / $231.18	Professional		$70.33	$160.90	$231.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $65.45 / $110.14 / $177.58	Professional		$65.45	$110.14	$177.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $65.05 / $135.19 / $447.41	Professional		$65.05	$135.19	$447.41
Midlands Facility/Professional Professional Modifier Low / Median / High Price $80.00 / $138.51 / $192.25	Professional		$80.00	$138.51	$192.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $23.56 / $83.38 / $164.52	Professional		$23.56	$83.38	$164.52
United Facility/Professional Professional Modifier Low / Median / High Price $63.70 / $99.49 / $165.87	Professional		$63.70	$99.49	$165.87
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $130.97 / $165.80 / $195.10	Professional		$130.97	$165.80	$195.10