Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.56 / $101.33 / $492.02	Professional		$77.56	$101.33	$492.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.22 / $207.26 / $244.76	Professional		$147.22	$207.26	$244.76
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $77.58 / $124.59 / $252.05	Professional		$77.58	$124.59	$252.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $118.11 / $205.99 / $534.04	Professional		$118.11	$205.99	$534.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $188.55 / $232.94	Professional		$120.00	$188.55	$232.94
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $105.00 / $105.00 / $249.10	Professional		$105.00	$105.00	$249.10
United Facility/Professional Professional Modifier Low / Median / High Price $100.49 / $155.30 / $248.47	Professional		$100.49	$155.30	$248.47
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $130.75 / $165.50 / $194.70	Professional		$130.75	$165.50	$194.70