Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $139.57 / $260.57 / $320.17	Facility		$139.57	$260.57	$320.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.70 / $72.70 / $470.16	Professional		$72.70	$72.70	$470.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.80 / $204.01 / $255.01	Professional		$122.80	$204.01	$255.01
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $94.41 / $164.69 / $269.63	Professional		$94.41	$164.69	$269.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $94.41 / $139.57 / $231.74	Facility		$94.41	$139.57	$231.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $56.65 / $94.41 / $303.70	Professional		$56.65	$94.41	$303.70
Midlands Facility/Professional Facility Modifier Low / Median / High Price $113.39 / $191.74 / $325.88	Facility		$113.39	$191.74	$325.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $105.63 / $189.53 / $231.70	Professional		$105.63	$189.53	$231.70
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $94.41 / $94.41 / $168.52	Professional		$94.41	$94.41	$168.52
United Facility/Professional Professional Modifier Low / Median / High Price $56.47 / $56.65 / $94.41	Professional		$56.47	$56.65	$94.41
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $74.58 / $94.41 / $94.41	Professional		$74.58	$94.41	$94.41