Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.79 / $223.10 / $378.24	Facility		$75.79	$223.10	$378.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.68 / $117.63 / $308.75	Professional		$53.68	$117.63	$308.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.60 / $155.19 / $243.47	Professional		$89.60	$155.19	$243.47
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $40.49 / $116.71 / $263.51	Professional		$40.49	$116.71	$263.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $70.13 / $154.88 / $392.86	Facility		$70.13	$154.88	$392.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $87.43 / $159.66 / $621.67	Professional		$87.43	$159.66	$621.67
Midlands Facility/Professional Facility Modifier Low / Median / High Price $85.37 / $122.39 / $214.79	Facility		$85.37	$122.39	$214.79
Midlands Facility/Professional Professional Modifier Low / Median / High Price $96.58 / $154.97 / $223.02	Professional		$96.58	$154.97	$223.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $43.02 / $88.21 / $165.94	Professional		$43.02	$88.21	$165.94
United Facility/Professional Facility Modifier Low / Median / High Price $1,151.00 / $1,775.00 / $3,560.25	Facility		$1,151.00	$1,775.00	$3,560.25
United Facility/Professional Professional Modifier Low / Median / High Price $80.31 / $121.65 / $228.09	Professional		$80.31	$121.65	$228.09
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $80.20 / $94.40 / $194.00	Professional		$80.20	$94.40	$194.00