Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.57 / $87.57 / $125.82	Professional		$87.57	$87.57	$125.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $396.91 / $493.61 / $558.15	Professional		$396.91	$493.61	$558.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $266.33 / $379.26 / $710.97	Professional		$266.33	$379.26	$710.97
Medica Facility/Professional Facility Modifier Low / Median / High Price $87.57 / $125.79 / $517.37	Facility		$87.57	$125.79	$517.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $396.91 / $493.61 / $614.00	Professional		$396.91	$493.61	$614.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $493.61 / $493.61 / $493.61	Facility		$493.61	$493.61	$493.61
Midlands Facility/Professional Professional Modifier Low / Median / High Price $396.91 / $493.61 / $493.61	Professional		$396.91	$493.61	$493.61
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $328.50 / $328.50 / $328.50	Professional		$328.50	$328.50	$328.50
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $293.17 / $371.10 / $371.10	Professional		$293.17	$371.10	$371.10