Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $141.25 / $630.96	Professional		$93.33	$141.25	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $213.80 / $263.03	Professional		$95.50	$213.80	$263.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $194.98 / $446.68	Professional		$89.13	$194.98	$446.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $186.21 / $676.08	Professional		$104.71	$186.21	$676.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $239.88 / $275.42	Professional		$199.53	$239.88	$275.42
Midlands Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $213.80 / $295.12	Professional		$177.83	$213.80	$295.12
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $177.83 / $229.09	Professional		$97.72	$177.83	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $138.04 / $229.09	Professional		$102.33	$138.04	$229.09
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $181.97 / $213.80	Professional		$141.25	$181.97	$213.80