Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $251.19 / $575.44	Facility		$91.20	$251.19	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $112.20 / $380.19	Professional		$58.88	$112.20	$380.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $158.49 / $245.47	Professional		$104.71	$158.49	$245.47
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $102.33 / $263.03	Professional		$60.26	$102.33	$263.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $158.49 / $1,023.29	Facility		$85.11	$158.49	$1,023.29
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $158.49 / $602.56	Professional		$85.11	$158.49	$602.56
Midlands Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $181.97 / $213.80	Professional		$134.90	$181.97	$213.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $158.49 / $213.80	Professional		$114.82	$158.49	$213.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $104.71 / $181.97	Professional		$57.54	$104.71	$181.97
United Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $1,202.26 / $2,344.23	Facility		$602.56	$1,202.26	$2,344.23
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $102.33 / $194.98	Professional		$61.66	$102.33	$194.98
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $134.90 / $190.55	Professional		$114.82	$134.90	$190.55