Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.73 / $149.33 / $558.90	Professional		$119.73	$149.33	$558.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.37 / $272.66 / $386.79	Professional		$138.37	$272.66	$386.79
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $130.75 / $195.72 / $1,221.63	Professional		$130.75	$195.72	$1,221.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $126.73 / $214.17 / $336.57	Facility		$126.73	$214.17	$336.57
Medica Facility/Professional Professional Modifier Low / Median / High Price $155.88 / $230.30 / $1,352.50	Professional		$155.88	$230.30	$1,352.50
Midlands Facility/Professional Facility Modifier Low / Median / High Price $203.30 / $268.54 / $373.80	Facility		$203.30	$268.54	$373.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $203.30 / $271.39 / $380.67	Professional		$203.30	$271.39	$380.67
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $128.10 / $228.66 / $260.11	Professional		$128.10	$228.66	$260.11
United Facility/Professional Professional Modifier Low / Median / High Price $147.15 / $194.26 / $329.05	Professional		$147.15	$194.26	$329.05
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $222.31 / $281.39 / $281.39	Professional		$222.31	$281.39	$281.39