Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $208.93 / $616.60	Professional		$128.82	$208.93	$616.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $288.40 / $363.08	Professional		$269.15	$288.40	$363.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $151.36 / $288.40	Professional		$109.65	$151.36	$288.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $194.98 / $389.05	Professional		$109.65	$194.98	$389.05
Midlands Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $269.15 / $380.19	Professional		$194.98	$269.15	$380.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $213.80 / $275.42	Professional		$117.49	$213.80	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $186.21 / $338.84	Professional		$114.82	$186.21	$338.84
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $199.53 / $234.42	Professional		$154.88	$199.53	$234.42