Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.62 / $149.81 / $178.70	Professional		$107.62	$149.81	$178.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.00 / $273.58 / $341.97	Professional		$161.00	$273.58	$341.97
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $115.38 / $157.66 / $362.52	Professional		$115.38	$157.66	$362.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $112.55 / $222.58 / $329.86	Facility		$112.55	$222.58	$329.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $141.37 / $276.61 / $839.64	Professional		$141.37	$276.61	$839.64
Midlands Facility/Professional Facility Modifier Low / Median / High Price $161.00 / $254.90 / $299.49	Facility		$161.00	$254.90	$299.49
Midlands Facility/Professional Professional Modifier Low / Median / High Price $161.00 / $254.90 / $299.49	Professional		$161.00	$254.90	$299.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $63.70 / $116.68 / $232.87	Professional		$63.70	$116.68	$232.87
United Facility/Professional Professional Modifier Low / Median / High Price $136.91 / $268.11 / $345.72	Professional		$136.91	$268.11	$345.72
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $205.08 / $259.60 / $305.39	Professional		$205.08	$259.60	$305.39