Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $158.49	Facility		$72.44	$72.44	$158.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $79.43 / $151.36	Professional		$64.57	$79.43	$151.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $239.88 / $245.47	Facility		$234.42	$239.88	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $194.98 / $245.47	Professional		$102.33	$194.98	$245.47
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $134.90 / $251.19	Professional		$74.13	$134.90	$251.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $199.53 / $602.56	Facility		$114.82	$199.53	$602.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $151.36 / $616.60	Professional		$81.28	$151.36	$616.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $186.21 / $218.78	Professional		$162.18	$186.21	$218.78
Midlands Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Facility		$245.47	$245.47	$245.47
Midlands Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $162.18 / $213.80	Professional		$144.54	$162.18	$213.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $56.23 / $134.90	Professional		$26.30	$56.23	$134.90
United Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $549.54 / $741.31	Facility		$316.23	$549.54	$741.31
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $100.00 / $177.83	Professional		$75.86	$100.00	$177.83
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $162.18	Professional		$138.04	$138.04	$162.18