Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $150.00 / $291.81 / $408.18	Facility		$150.00	$291.81	$408.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.00 / $115.50 / $145.50	Professional		$99.00	$115.50	$145.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $156.75 / $180.00 / $195.94	Professional		$156.75	$180.00	$195.94
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $202.50 / $271.50	Professional		$150.00	$202.50	$271.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $142.50 / $195.00 / $423.41	Facility		$142.50	$195.00	$423.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $150.00 / $590.11	Professional		$90.00	$150.00	$590.11
Midlands Facility/Professional Facility Modifier Low / Median / High Price $180.00 / $285.56 / $423.41	Facility		$180.00	$285.56	$423.41
Midlands Facility/Professional Professional Modifier Low / Median / High Price $180.00 / $291.14 / $382.50	Professional		$180.00	$291.14	$382.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $145.94 / $150.00 / $267.75	Professional		$145.94	$150.00	$267.75
United Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $90.00 / $307.13	Professional		$90.00	$90.00	$307.13
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $150.00 / $150.00	Professional		$150.00	$150.00	$150.00