Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $131.83 / $524.81	Professional		$107.15	$131.83	$524.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $245.47 / $309.03	Professional		$112.20	$245.47	$309.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $186.21 / $380.19	Professional		$104.71	$186.21	$380.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $186.21 / $776.25	Professional		$112.20	$186.21	$776.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $257.04 / $309.03	Professional		$194.98	$257.04	$309.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $218.78 / $338.84	Professional		$181.97	$218.78	$338.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $208.93 / $275.42	Professional		$117.49	$208.93	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $147.91 / $263.03	Professional		$112.20	$147.91	$263.03
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $208.93 / $251.19	Professional		$165.96	$208.93	$251.19