Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $263.03 / $380.19	Facility		$104.71	$263.03	$380.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $114.82 / $173.78	Professional		$95.50	$114.82	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $263.03 / $331.13	Professional		$177.83	$263.03	$331.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $245.47 / $380.19	Professional		$151.36	$245.47	$380.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $165.96 / $346.74	Facility		$138.04	$165.96	$346.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $141.25 / $549.54	Professional		$81.28	$141.25	$549.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $177.83	Professional		$165.96	$165.96	$177.83
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $147.91 / $295.12	Professional		$138.04	$147.91	$295.12
United Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $316.23	Facility		$138.04	$138.04	$316.23
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $346.74	Professional		$81.28	$81.28	$346.74
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Professional		$138.04	$138.04	$138.04