Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.40 / $184.79 / $258.48	Facility		$102.40	$184.79	$258.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.69 / $82.64 / $92.14	Professional		$62.69	$82.64	$92.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.08 / $172.99 / $216.24	Professional		$114.08	$172.99	$216.24
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $104.49 / $133.88 / $166.23	Professional		$104.49	$133.88	$166.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $94.99 / $122.58 / $246.55	Facility		$94.99	$122.58	$246.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $56.99 / $94.99 / $372.87	Professional		$56.99	$94.99	$372.87
Midlands Facility/Professional Facility Modifier Low / Median / High Price $113.99 / $174.17 / $211.09	Facility		$113.99	$174.17	$211.09
Midlands Facility/Professional Professional Modifier Low / Median / High Price $113.99 / $174.17 / $242.22	Professional		$113.99	$174.17	$242.22
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $94.99 / $94.99 / $169.56	Professional		$94.99	$94.99	$169.56
United Facility/Professional Professional Modifier Low / Median / High Price $56.99 / $56.99 / $207.08	Professional		$56.99	$56.99	$207.08
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $94.99 / $94.99 / $94.99	Professional		$94.99	$94.99	$94.99