Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $93.33 / $147.91	Facility		$60.26	$93.33	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $52.48 / $120.23	Professional		$40.74	$52.48	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $117.49 / $131.83	Professional		$104.71	$117.49	$131.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $91.20 / $323.59	Professional		$47.86	$91.20	$323.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $125.89 / $1,905.46	Facility		$83.18	$125.89	$1,905.46
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $95.50 / $371.54	Professional		$54.95	$95.50	$371.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $117.49 / $190.55	Professional		$109.65	$117.49	$190.55
Midlands Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $134.90 / $134.90	Professional		$100.00	$134.90	$134.90
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $109.65 / $123.03	Professional		$97.72	$109.65	$123.03
United Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,621.81 / $3,548.13	Facility		$1,148.15	$1,621.81	$3,548.13
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $79.43 / $151.36	Professional		$52.48	$79.43	$151.36
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $112.20	Professional		$95.50	$95.50	$112.20