Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $163.96 / $318.97 / $446.17	Facility		$163.96	$318.97	$446.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.21 / $126.25 / $159.04	Professional		$108.21	$126.25	$159.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $196.75 / $297.68 / $372.10	Professional		$196.75	$297.68	$372.10
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $221.35 / $838.02	Professional		$150.00	$221.35	$838.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $163.96 / $213.15 / $388.50	Facility		$163.96	$213.15	$388.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $98.38 / $163.96 / $794.57	Professional		$98.38	$163.96	$794.57
Midlands Facility/Professional Facility Modifier Low / Median / High Price $196.75 / $321.39 / $359.33	Facility		$196.75	$321.39	$359.33
Midlands Facility/Professional Professional Modifier Low / Median / High Price $196.75 / $346.83 / $418.10	Professional		$196.75	$346.83	$418.10
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $159.53 / $163.96 / $292.67	Professional		$159.53	$163.96	$292.67
United Facility/Professional Professional Modifier Low / Median / High Price $98.38 / $98.38 / $397.15	Professional		$98.38	$98.38	$397.15
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $163.96 / $163.96 / $163.96	Professional		$163.96	$163.96	$163.96