Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $169.82 / $380.19	Professional		$123.03	$169.82	$380.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $263.03 / $323.59	Professional		$117.49	$263.03	$323.59
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $234.42 / $602.56	Professional		$109.65	$234.42	$602.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $229.09 / $891.25	Professional		$134.90	$229.09	$891.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $295.12 / $338.84	Professional		$263.03	$295.12	$338.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $269.15 / $398.11	Professional		$218.78	$269.15	$398.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $239.88 / $316.23	Professional		$131.83	$239.88	$316.23
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $173.78 / $309.03	Professional		$131.83	$173.78	$309.03
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $223.87 / $263.03	Professional		$173.78	$223.87	$263.03