Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $122.39 / $174.84 / $390.23	Professional		$122.39	$174.84	$390.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.46 / $265.83 / $358.81	Professional		$119.46	$265.83	$358.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $103.96 / $177.95 / $529.79	Professional		$103.96	$177.95	$529.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $147.22 / $265.27 / $886.02	Professional		$147.22	$265.27	$886.02
Midlands Facility/Professional Professional Modifier Low / Median / High Price $216.82 / $272.48 / $342.52	Professional		$216.82	$272.48	$342.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $118.63 / $205.68 / $277.23	Professional		$118.63	$205.68	$277.23
United Facility/Professional Professional Modifier Low / Median / High Price $140.80 / $186.31 / $312.97	Professional		$140.80	$186.31	$312.97
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $175.78 / $222.50 / $261.80	Professional		$175.78	$222.50	$261.80