Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $151.36 / $204.17	Professional		$85.11	$151.36	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $295.12 / $363.08	Professional		$91.20	$295.12	$363.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $204.17 / $251.19	Professional		$162.18	$204.17	$251.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $194.98 / $269.15	Facility		$154.88	$194.98	$269.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $95.50 / $162.18	Professional		$75.86	$95.50	$162.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $371.54 / $371.54	Professional		$213.80	$371.54	$371.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $281.84 / $457.09	Professional		$194.98	$281.84	$457.09
United Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Facility		$194.98	$194.98	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $95.50 / $120.23	Professional		$79.43	$95.50	$120.23
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Professional		$169.82	$169.82	$169.82