Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.73 / $133.37 / $461.27	Professional		$109.73	$133.37	$461.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.83 / $251.86 / $355.17	Professional		$129.83	$251.86	$355.17
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $122.35 / $182.99 / $973.12	Professional		$122.35	$182.99	$973.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $118.31 / $201.13 / $307.20	Facility		$118.31	$201.13	$307.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $146.41 / $216.63 / $1,352.50	Professional		$146.41	$216.63	$1,352.50
Midlands Facility/Professional Facility Modifier Low / Median / High Price $190.20 / $251.86 / $350.18	Facility		$190.20	$251.86	$350.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $190.20 / $255.29 / $350.18	Professional		$190.20	$255.29	$350.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $120.19 / $214.54 / $243.12	Professional		$120.19	$214.54	$243.12
United Facility/Professional Professional Modifier Low / Median / High Price $139.76 / $185.17 / $309.06	Professional		$139.76	$185.17	$309.06
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $208.01 / $263.30 / $263.30	Professional		$208.01	$263.30	$263.30