Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.83 / $108.43 / $198.90	Professional		$92.83	$108.43	$198.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.42 / $157.19 / $257.13	Professional		$96.42	$157.19	$257.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $93.63 / $103.59 / $295.55	Professional		$93.63	$103.59	$295.55
Medica Facility/Professional Facility Modifier Low / Median / High Price $112.66 / $176.05 / $241.35	Facility		$112.66	$176.05	$241.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $125.11 / $208.88 / $698.47	Professional		$125.11	$208.88	$698.47
Midlands Facility/Professional Facility Modifier Low / Median / High Price $135.59 / $157.19 / $271.47	Facility		$135.59	$157.19	$271.47
Midlands Facility/Professional Professional Modifier Low / Median / High Price $140.62 / $176.66 / $257.13	Professional		$140.62	$176.66	$257.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $137.80 / $194.10 / $279.20	Professional		$137.80	$194.10	$279.20
United Facility/Professional Professional Modifier Low / Median / High Price $114.40 / $177.99 / $295.91	Professional		$114.40	$177.99	$295.91
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $151.76 / $192.10 / $226.00	Professional		$151.76	$192.10	$226.00