Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $156.13 / $281.77 / $615.46	Facility		$156.13	$281.77	$615.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.53 / $126.01 / $211.90	Professional		$111.53	$126.01	$211.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.96 / $263.08 / $328.85	Professional		$173.96	$263.08	$328.85
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $144.84 / $217.26 / $262.16	Professional		$144.84	$217.26	$262.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $144.84 / $188.29 / $406.18	Facility		$144.84	$188.29	$406.18
Medica Facility/Professional Professional Modifier Low / Median / High Price $86.90 / $149.19 / $724.20	Professional		$86.90	$149.19	$724.20
Midlands Facility/Professional Facility Modifier Low / Median / High Price $173.81 / $295.08 / $406.18	Facility		$173.81	$295.08	$406.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $173.96 / $295.08 / $414.94	Professional		$173.96	$295.08	$414.94
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $358.77 / $358.77 / $358.77	Facility		$358.77	$358.77	$358.77
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $144.84 / $144.84 / $258.54	Professional		$144.84	$144.84	$258.54
United Facility/Professional Professional Modifier Low / Median / High Price $86.90 / $86.90 / $297.72	Professional		$86.90	$86.90	$297.72
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $144.84 / $144.84 / $144.84	Professional		$144.84	$144.84	$144.84