Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $331.13 / $6,760.83	Facility		$87.10	$331.13	$6,760.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $91.20 / $251.19	Professional		$53.70	$91.20	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $131.83 / $199.53	Professional		$58.88	$131.83	$199.53
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $81.28 / $177.83	Professional		$45.71	$81.28	$177.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $169.82 / $1,621.81	Facility		$107.15	$169.82	$1,621.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $134.90 / $380.19	Professional		$83.18	$134.90	$380.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $147.91 / $181.97	Professional		$117.49	$147.91	$181.97
Midlands Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Professional		$131.83	$131.83	$131.83
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $77.62 / $141.25	Professional		$42.66	$77.62	$141.25
United Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $1,202.26 / $2,344.23	Facility		$288.40	$1,202.26	$2,344.23
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $93.33 / $181.97	Professional		$60.26	$93.33	$181.97
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $109.65 / $151.36	Professional		$93.33	$109.65	$151.36