Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.57 / $129.13 / $175.33	Professional		$98.57	$129.13	$175.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.02 / $259.61 / $385.99	Professional		$133.02	$259.61	$385.99
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $103.19 / $138.84 / $227.43	Professional		$103.19	$138.84	$227.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $114.08 / $175.28 / $286.04	Facility		$114.08	$175.28	$286.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $126.98 / $308.75 / $794.81	Professional		$126.98	$308.75	$794.81
Midlands Facility/Professional Facility Modifier Low / Median / High Price $244.69 / $259.61 / $328.18	Facility		$244.69	$259.61	$328.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $244.69 / $265.87 / $343.35	Professional		$244.69	$265.87	$343.35
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $92.48 / $123.31 / $232.78	Professional		$92.48	$123.31	$232.78
United Facility/Professional Professional Modifier Low / Median / High Price $100.75 / $213.86 / $363.56	Professional		$100.75	$213.86	$363.56
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $196.90 / $213.80 / $251.50	Professional		$196.90	$213.80	$251.50