Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.75 / $218.12 / $332.59	Facility		$131.75	$218.12	$332.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.67 / $106.33 / $144.90	Professional		$80.67	$106.33	$144.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.79 / $221.95 / $277.44	Professional		$146.79	$221.95	$277.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $134.44 / $190.72 / $221.22	Professional		$134.44	$190.72	$221.22
Medica Facility/Professional Facility Modifier Low / Median / High Price $122.22 / $157.72 / $312.88	Facility		$122.22	$157.72	$312.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $73.33 / $122.22 / $592.29	Professional		$73.33	$122.22	$592.29
Midlands Facility/Professional Facility Modifier Low / Median / High Price $146.66 / $249.00 / $335.33	Facility		$146.66	$249.00	$335.33
Midlands Facility/Professional Professional Modifier Low / Median / High Price $146.66 / $249.00 / $332.48	Professional		$146.66	$249.00	$332.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $122.22 / $122.22 / $218.16	Professional		$122.22	$122.22	$218.16
United Facility/Professional Professional Modifier Low / Median / High Price $73.33 / $73.33 / $309.08	Professional		$73.33	$73.33	$309.08
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $122.22 / $122.22 / $122.22	Professional		$122.22	$122.22	$122.22