Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.59 / $191.07 / $265.58	Facility		$83.59	$191.07	$265.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.37 / $81.59 / $169.00	Professional		$47.37	$81.59	$169.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.03 / $149.97 / $250.16	Professional		$109.03	$149.97	$250.16
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $52.33 / $116.81 / $201.18	Professional		$52.33	$116.81	$201.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $81.59 / $138.05 / $392.86	Facility		$81.59	$138.05	$392.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $87.22 / $156.43 / $562.70	Professional		$87.22	$156.43	$562.70
Midlands Facility/Professional Facility Modifier Low / Median / High Price $104.81 / $130.04 / $223.79	Facility		$104.81	$130.04	$223.79
Midlands Facility/Professional Professional Modifier Low / Median / High Price $103.36 / $147.41 / $231.32	Professional		$103.36	$147.41	$231.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $55.80 / $104.79 / $181.79	Professional		$55.80	$104.79	$181.79
United Facility/Professional Facility Modifier Low / Median / High Price $1,204.00 / $1,640.00 / $2,126.00	Facility		$1,204.00	$1,640.00	$2,126.00
United Facility/Professional Professional Modifier Low / Median / High Price $83.25 / $126.86 / $236.28	Professional		$83.25	$126.86	$236.28
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $103.30 / $121.60 / $213.70	Professional		$103.30	$121.60	$213.70