Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.51 / $172.42 / $212.97	Facility		$109.51	$172.42	$212.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.41 / $157.91 / $469.37	Professional		$49.41	$157.91	$469.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.90 / $135.78 / $169.73	Professional		$85.90	$135.78	$169.73
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $82.35 / $112.29 / $285.61	Professional		$82.35	$112.29	$285.61
Medica Facility/Professional Facility Modifier Low / Median / High Price $74.86 / $100.57 / $355.59	Facility		$74.86	$100.57	$355.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.92 / $74.86 / $207.62	Professional		$44.92	$74.86	$207.62
Midlands Facility/Professional Facility Modifier Low / Median / High Price $89.91 / $154.21 / $209.40	Facility		$89.91	$154.21	$209.40
Midlands Facility/Professional Professional Modifier Low / Median / High Price $89.83 / $152.52 / $207.62	Professional		$89.83	$152.52	$207.62
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $124.94 / $124.94 / $124.94	Facility		$124.94	$124.94	$124.94
United Facility/Professional Professional Modifier Low / Median / High Price $44.92 / $61.18 / $172.18	Professional		$44.92	$61.18	$172.18
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $59.14 / $74.86 / $74.86	Professional		$59.14	$74.86	$74.86