Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.16 / $153.58 / $192.72	Professional		$130.16	$153.58	$192.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.11 / $293.25 / $366.56	Professional		$91.11	$293.25	$366.56
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $161.35 / $209.28 / $253.09	Professional		$161.35	$209.28	$253.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $158.15 / $203.67 / $370.15	Facility		$158.15	$203.67	$370.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $87.56 / $94.70 / $189.40	Professional		$87.56	$94.70	$189.40
Midlands Facility/Professional Facility Modifier Low / Median / High Price $189.05 / $208.80 / $370.15	Facility		$189.05	$208.80	$370.15
Midlands Facility/Professional Professional Modifier Low / Median / High Price $168.20 / $189.05 / $370.15	Professional		$168.20	$189.05	$370.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $189.82 / $258.16 / $460.82	Professional		$189.82	$258.16	$460.82
United Facility/Professional Professional Modifier Low / Median / High Price $74.15 / $94.70 / $121.25	Professional		$74.15	$94.70	$121.25
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $134.96 / $170.84 / $170.84	Professional		$134.96	$170.84	$170.84