Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.80 / $118.24 / $150.54	Professional		$87.80	$118.24	$150.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.76 / $163.50 / $204.38	Professional		$67.76	$163.50	$204.38
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $119.99 / $141.16 / $188.88	Professional		$119.99	$141.16	$188.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $92.49 / $141.16 / $275.26	Facility		$92.49	$141.16	$275.26
Medica Facility/Professional Professional Modifier Low / Median / High Price $65.11 / $70.42 / $139.00	Professional		$65.11	$70.42	$139.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $139.00 / $155.28 / $275.26	Facility		$139.00	$155.28	$275.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $125.08 / $140.59 / $275.26	Professional		$125.08	$140.59	$275.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $143.97 / $257.00	Professional		$50.00	$143.97	$257.00
United Facility/Professional Professional Modifier Low / Median / High Price $56.24 / $70.42 / $90.18	Professional		$56.24	$70.42	$90.18
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $100.36 / $127.04 / $127.04	Professional		$100.36	$127.04	$127.04