Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.92 / $96.54 / $133.55	Professional		$81.92	$96.54	$133.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.00 / $191.21 / $289.77	Professional		$73.00	$191.21	$289.77
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $77.87 / $106.64 / $176.89	Professional		$77.87	$106.64	$176.89
Medica Facility/Professional Facility Modifier Low / Median / High Price $83.50 / $125.00 / $205.67	Facility		$83.50	$125.00	$205.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $76.89 / $192.84 / $613.89	Professional		$76.89	$192.84	$613.89
Midlands Facility/Professional Facility Modifier Low / Median / High Price $180.85 / $203.17 / $239.53	Facility		$180.85	$203.17	$239.53
Midlands Facility/Professional Professional Modifier Low / Median / High Price $171.17 / $212.07 / $250.54	Professional		$171.17	$212.07	$250.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $75.11 / $102.00 / $188.50	Professional		$75.11	$102.00	$188.50
United Facility/Professional Professional Modifier Low / Median / High Price $75.11 / $125.00 / $254.47	Professional		$75.11	$125.00	$254.47
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $112.00 / $127.90 / $150.50	Professional		$112.00	$127.90	$150.50