Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $93.33	Facility		$57.54	$57.54	$93.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $72.44 / $190.55	Professional		$42.66	$72.44	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $177.83 / $223.87	Professional		$104.71	$177.83	$223.87
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $131.83 / $213.80	Professional		$61.66	$131.83	$213.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $165.96 / $1,380.38	Facility		$81.28	$165.96	$1,380.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $141.25 / $346.74	Professional		$81.28	$141.25	$346.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $147.91 / $213.80	Professional		$109.65	$147.91	$213.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $128.82 / $204.17	Professional		$93.33	$128.82	$204.17
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.02 / $120.23 / $204.17	Professional		$3.02	$120.23	$204.17
United Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $1,202.26 / $2,344.23	Facility		$436.52	$1,202.26	$2,344.23
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $100.00 / $181.97	Professional		$54.95	$100.00	$181.97
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $104.71 / $173.78	Professional		$89.13	$104.71	$173.78