Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.09 / $39.09 / $39.09	Facility		$39.09	$39.09	$39.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.67 / $105.06 / $116.96	Professional		$75.67	$105.06	$116.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $155.03 / $184.90 / $197.70	Professional		$155.03	$184.90	$197.70
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $63.26 / $113.90 / $175.38	Professional		$63.26	$113.90	$175.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $84.42 / $172.00 / $1,607.00	Facility		$84.42	$172.00	$1,607.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $80.16 / $156.62 / $519.52	Professional		$80.16	$156.62	$519.52
Midlands Facility/Professional Facility Modifier Low / Median / High Price $53.65 / $112.00 / $189.76	Facility		$53.65	$112.00	$189.76
Midlands Facility/Professional Professional Modifier Low / Median / High Price $103.00 / $155.03 / $203.44	Professional		$103.00	$155.03	$203.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $107.60 / $145.60 / $182.90	Professional		$107.60	$145.60	$182.90
United Facility/Professional Facility Modifier Low / Median / High Price $1,204.00 / $1,607.00 / $2,126.00	Facility		$1,204.00	$1,607.00	$2,126.00
United Facility/Professional Professional Modifier Low / Median / High Price $74.43 / $133.33 / $210.68	Professional		$74.43	$133.33	$210.68
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $134.30 / $134.30 / $158.00	Professional		$134.30	$134.30	$158.00