Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.27 / $126.09 / $144.12	Professional		$93.27	$126.09	$144.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $168.19 / $239.67 / $305.45	Professional		$168.19	$239.67	$305.45
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $105.86 / $151.49 / $481.10	Professional		$105.86	$151.49	$481.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $96.24 / $144.12 / $258.02	Facility		$96.24	$144.12	$258.02
Medica Facility/Professional Professional Modifier Low / Median / High Price $142.75 / $240.36 / $662.29	Professional		$142.75	$240.36	$662.29
Midlands Facility/Professional Facility Modifier Low / Median / High Price $197.40 / $239.67 / $272.11	Facility		$197.40	$239.67	$272.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $197.40 / $239.67 / $279.58	Professional		$197.40	$239.67	$279.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $93.59 / $160.44 / $201.35	Professional		$93.59	$160.44	$201.35
United Facility/Professional Professional Modifier Low / Median / High Price $120.70 / $214.64 / $285.49	Professional		$120.70	$214.64	$285.49
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $166.06 / $210.20 / $247.30	Professional		$166.06	$210.20	$247.30