Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Facility		$125.89	$125.89	$125.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $79.43 / $194.98	Professional		$72.44	$79.43	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $190.55 / $223.87	Professional		$181.97	$190.55	$223.87
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $147.91 / $1,380.38	Professional		$79.43	$147.91	$1,380.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $549.54 / $1,621.81	Facility		$109.65	$549.54	$1,621.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $158.49 / $660.69	Professional		$93.33	$158.49	$660.69
Midlands Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $190.55 / $302.00	Professional		$151.36	$190.55	$302.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $208.93 / $208.93	Professional		$147.91	$208.93	$208.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $165.96 / $194.98	Professional		$151.36	$165.96	$194.98
United Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $1,380.38 / $2,344.23	Facility		$812.83	$1,380.38	$2,344.23
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $131.83 / $257.04	Professional		$85.11	$131.83	$257.04
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $173.78	Professional		$147.91	$147.91	$173.78