Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.92 / $133.69 / $516.00	Professional		$107.92	$133.69	$516.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.76 / $210.72 / $355.17	Professional		$115.76	$210.72	$355.17
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $106.69 / $124.14 / $429.94	Professional		$106.69	$124.14	$429.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $135.91 / $220.87 / $289.70	Facility		$135.91	$220.87	$289.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $151.04 / $281.55 / $827.90	Professional		$151.04	$281.55	$827.90
Midlands Facility/Professional Facility Modifier Low / Median / High Price $161.03 / $188.75 / $331.92	Facility		$161.03	$188.75	$331.92
Midlands Facility/Professional Professional Modifier Low / Median / High Price $166.73 / $217.03 / $331.92	Professional		$166.73	$217.03	$331.92
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $147.80 / $147.80 / $147.80	Professional		$147.80	$147.80	$147.80
United Facility/Professional Professional Modifier Low / Median / High Price $144.47 / $248.18 / $357.24	Professional		$144.47	$248.18	$357.24
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $145.44 / $184.10 / $184.10	Professional		$145.44	$184.10	$184.10