Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.86 / $148.33 / $176.50	Professional		$115.86	$148.33	$176.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.76 / $258.75 / $323.44	Professional		$86.76	$258.75	$323.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $153.63 / $183.35 / $223.26	Professional		$153.63	$183.35	$223.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $150.58 / $196.74 / $357.53	Facility		$150.58	$196.74	$357.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $84.56 / $91.47 / $182.94	Professional		$84.56	$91.47	$182.94
Midlands Facility/Professional Facility Modifier Low / Median / High Price $182.60 / $201.69 / $357.53	Facility		$182.60	$201.69	$357.53
Midlands Facility/Professional Professional Modifier Low / Median / High Price $162.46 / $182.60 / $357.53	Professional		$162.46	$182.60	$357.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $183.35 / $227.73 / $406.50	Professional		$183.35	$227.73	$406.50
United Facility/Professional Professional Modifier Low / Median / High Price $72.00 / $91.47 / $157.02	Professional		$72.00	$91.47	$157.02
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $130.37 / $165.02 / $165.02	Professional		$130.37	$165.02	$165.02