Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.68 / $159.47 / $241.14	Professional		$74.68	$159.47	$241.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $189.73 / $272.32 / $391.52	Professional		$189.73	$272.32	$391.52
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $114.02 / $171.02 / $612.02	Professional		$114.02	$171.02	$612.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $114.02 / $250.83 / $698.44	Facility		$114.02	$250.83	$698.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $135.21 / $388.69 / $999.25	Professional		$135.21	$388.69	$999.25
Midlands Facility/Professional Facility Modifier Low / Median / High Price $189.73 / $390.52 / $399.51	Facility		$189.73	$390.52	$399.51
Midlands Facility/Professional Professional Modifier Low / Median / High Price $189.73 / $390.52 / $399.51	Professional		$189.73	$390.52	$399.51
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $124.40 / $2,290.03 / $2,478.96	Professional		$124.40	$2,290.03	$2,478.96
United Facility/Professional Professional Modifier Low / Median / High Price $137.57 / $388.69 / $660.77	Professional		$137.57	$388.69	$660.77
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $246.01 / $311.39 / $311.39	Professional		$246.01	$311.39	$311.39