Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.75 / $48.75 / $48.75	Professional		$48.75	$48.75	$48.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $264.64 / $308.98 / $330.82	Professional		$264.64	$308.98	$330.82
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $141.02 / $194.32 / $250.20	Professional		$141.02	$194.32	$250.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $48.75 / $82.39 / $288.00	Facility		$48.75	$82.39	$288.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $273.82 / $273.82 / $901.00	Professional		$273.82	$273.82	$901.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $273.82 / $273.82 / $273.82	Professional		$273.82	$273.82	$273.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Professional		$100.00	$100.00	$100.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $189.36 / $239.70 / $239.70	Professional		$189.36	$239.70	$239.70