Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.98 / $123.44 / $425.18	Professional		$93.98	$123.44	$425.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.63 / $171.00 / $213.75	Professional		$158.63	$171.00	$213.75
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $147.37 / $156.04 / $266.74	Professional		$147.37	$156.04	$266.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $123.44 / $167.90 / $325.27	Facility		$123.44	$167.90	$325.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $70.91 / $90.41 / $365.86	Professional		$70.91	$90.41	$365.86
Midlands Facility/Professional Facility Modifier Low / Median / High Price $161.63 / $167.90 / $212.10	Facility		$161.63	$167.90	$212.10
Midlands Facility/Professional Professional Modifier Low / Median / High Price $161.63 / $184.88 / $246.58	Professional		$161.63	$184.88	$246.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $140.00 / $182.40 / $268.32	Professional		$140.00	$182.40	$268.32
United Facility/Professional Professional Modifier Low / Median / High Price $69.95 / $73.52 / $126.21	Professional		$69.95	$73.52	$126.21
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $132.63 / $132.63 / $132.63	Facility		$132.63	$132.63	$132.63
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $104.78 / $132.63 / $132.63	Professional		$104.78	$132.63	$132.63