Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.89 / $157.57 / $620.00	Professional		$120.89	$157.57	$620.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $143.72 / $302.92 / $383.06	Professional		$143.72	$302.92	$383.06
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $136.21 / $199.20 / $458.98	Professional		$136.21	$199.20	$458.98
Medica Facility/Professional Facility Modifier Low / Median / High Price $134.16 / $197.20 / $326.91	Facility		$134.16	$197.20	$326.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $187.82 / $325.87 / $831.61	Professional		$187.82	$325.87	$831.61
Midlands Facility/Professional Facility Modifier Low / Median / High Price $255.21 / $302.92 / $344.51	Facility		$255.21	$302.92	$344.51
Midlands Facility/Professional Professional Modifier Low / Median / High Price $261.22 / $308.39 / $350.69	Professional		$261.22	$308.39	$350.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $121.18 / $215.81 / $258.86	Professional		$121.18	$215.81	$258.86
United Facility/Professional Professional Modifier Low / Median / High Price $151.72 / $272.70 / $358.85	Professional		$151.72	$272.70	$358.85
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $212.98 / $269.60 / $317.10	Professional		$212.98	$269.60	$317.10