Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.00 / $208.16 / $291.17	Facility		$107.00	$208.16	$291.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.62 / $103.79 / $103.79	Professional		$70.62	$103.79	$103.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.40 / $194.53 / $243.17	Professional		$128.40	$194.53	$243.17
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $117.70 / $150.00 / $193.67	Professional		$117.70	$150.00	$193.67
Medica Facility/Professional Facility Modifier Low / Median / High Price $107.00 / $138.08 / $273.92	Facility		$107.00	$138.08	$273.92
Medica Facility/Professional Professional Modifier Low / Median / High Price $64.20 / $107.00 / $420.95	Professional		$64.20	$107.00	$420.95
Midlands Facility/Professional Facility Modifier Low / Median / High Price $128.40 / $203.70 / $302.04	Facility		$128.40	$203.70	$302.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $128.40 / $207.69 / $272.85	Professional		$128.40	$207.69	$272.85
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $104.11 / $107.00 / $191.00	Professional		$104.11	$107.00	$191.00
United Facility/Professional Professional Modifier Low / Median / High Price $64.20 / $64.20 / $233.26	Professional		$64.20	$64.20	$233.26
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $107.00 / $107.00 / $107.00	Professional		$107.00	$107.00	$107.00