Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.03 / $57.00 / $218.45	Facility		$32.03	$57.00	$218.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.88 / $138.03 / $202.38	Professional		$110.88	$138.03	$202.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $410.61 / $422.93 / $435.25	Facility		$410.61	$422.93	$435.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.27 / $223.98 / $505.19	Professional		$124.27	$223.98	$505.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $149.68 / $201.02 / $527.88	Professional		$149.68	$201.02	$527.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $153.21 / $242.93 / $577.51	Facility		$153.21	$242.93	$577.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $151.34 / $237.18 / $577.51	Professional		$151.34	$237.18	$577.51
Midlands Facility/Professional Facility Modifier Low / Median / High Price $238.69 / $338.03 / $537.78	Facility		$238.69	$338.03	$537.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $238.69 / $338.03 / $574.08	Professional		$238.69	$338.03	$574.08
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $188.72 / $402.53 / $819.43	Facility		$188.72	$402.53	$819.43
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $22.78 / $50.30 / $74.88	Professional		$22.78	$50.30	$74.88
United Facility/Professional Professional Modifier Low / Median / High Price $155.97 / $189.74 / $341.54	Professional		$155.97	$189.74	$341.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $295.54 / $374.10 / $440.10	Professional		$295.54	$374.10	$440.10