Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.11 / $185.48 / $755.52	Professional		$123.11	$185.48	$755.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.64 / $269.11 / $363.09	Professional		$122.64	$269.11	$363.09
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $107.06 / $182.43 / $527.44	Professional		$107.06	$182.43	$527.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $141.27 / $265.85 / $976.46	Professional		$141.27	$265.85	$976.46
Midlands Facility/Professional Professional Modifier Low / Median / High Price $220.20 / $286.04 / $352.18	Professional		$220.20	$286.04	$352.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $108.44 / $193.57 / $244.49	Professional		$108.44	$193.57	$244.49
United Facility/Professional Professional Modifier Low / Median / High Price $137.04 / $199.07 / $299.24	Professional		$137.04	$199.07	$299.24
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $180.83 / $228.90 / $269.20	Professional		$180.83	$228.90	$269.20