Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.13 / $260.94 / $364.99	Facility		$134.13	$260.94	$364.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.53 / $116.69 / $130.11	Professional		$88.53	$116.69	$130.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.96 / $244.15 / $305.18	Professional		$160.96	$244.15	$305.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $147.54 / $181.08 / $685.55	Professional		$147.54	$181.08	$685.55
Medica Facility/Professional Facility Modifier Low / Median / High Price $134.13 / $173.09 / $343.37	Facility		$134.13	$173.09	$343.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $80.48 / $90.00 / $503.96	Professional		$80.48	$90.00	$503.96
Midlands Facility/Professional Facility Modifier Low / Median / High Price $160.96 / $187.78 / $293.97	Facility		$160.96	$187.78	$293.97
Midlands Facility/Professional Professional Modifier Low / Median / High Price $160.96 / $245.29 / $350.08	Professional		$160.96	$245.29	$350.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $130.51 / $134.13 / $239.42	Professional		$130.51	$134.13	$239.42
United Facility/Professional Facility Modifier Low / Median / High Price $201.20 / $201.20 / $201.20	Facility		$201.20	$201.20	$201.20
United Facility/Professional Professional Modifier Low / Median / High Price $80.48 / $80.48 / $292.39	Professional		$80.48	$80.48	$292.39
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $134.13 / $134.13 / $134.13	Professional		$134.13	$134.13	$134.13