Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.52 / $184.73 / $770.21	Professional		$119.52	$184.73	$770.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.00 / $176.25 / $282.18	Professional		$141.00	$176.25	$282.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $108.53 / $109.61 / $478.45	Professional		$108.53	$109.61	$478.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $136.46 / $186.06 / $454.54	Professional		$136.46	$186.06	$454.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $160.88 / $221.19 / $347.08	Professional		$160.88	$221.19	$347.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $108.71 / $195.55 / $237.71	Professional		$108.71	$195.55	$237.71
United Facility/Professional Professional Modifier Low / Median / High Price $130.10 / $169.42 / $359.07	Professional		$130.10	$169.42	$359.07
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $179.17 / $226.80 / $266.80	Professional		$179.17	$226.80	$266.80