Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.01 / $231.30 / $745.00	Professional		$120.01	$231.30	$745.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.90 / $268.75 / $363.09	Professional		$124.90	$268.75	$363.09
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $108.88 / $185.84 / $403.68	Professional		$108.88	$185.84	$403.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $141.54 / $264.44 / $907.92	Professional		$141.54	$264.44	$907.92
Midlands Facility/Professional Professional Modifier Low / Median / High Price $212.30 / $291.81 / $337.68	Professional		$212.30	$291.81	$337.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $110.56 / $197.35 / $244.74	Professional		$110.56	$197.35	$244.74
United Facility/Professional Professional Modifier Low / Median / High Price $135.62 / $196.87 / $348.74	Professional		$135.62	$196.87	$348.74
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $183.75 / $232.60 / $273.70	Professional		$183.75	$232.60	$273.70