Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $204.17 / $331.13	Facility		$93.33	$204.17	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $107.15 / $190.55	Professional		$85.11	$107.15	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $234.42 / $295.12	Professional		$158.49	$234.42	$295.12
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $190.55 / $218.78	Professional		$131.83	$190.55	$218.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $151.36 / $316.23	Facility		$123.03	$151.36	$316.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $147.91 / $588.84	Professional		$74.13	$147.91	$588.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $158.49	Professional		$147.91	$147.91	$158.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $131.83 / $263.03	Professional		$123.03	$131.83	$263.03
United Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $281.84	Facility		$123.03	$123.03	$281.84
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $75.86 / $309.03	Professional		$74.13	$75.86	$309.03
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Professional		$123.03	$123.03	$123.03