Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.12 / $225.02 / $330.99	Facility		$131.12	$225.02	$330.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.66 / $105.82 / $207.81	Professional		$93.66	$105.82	$207.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.07 / $220.65 / $275.81	Professional		$146.07	$220.65	$275.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $133.79 / $212.85 / $429.43	Professional		$133.79	$212.85	$429.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $121.63 / $158.29 / $331.60	Facility		$121.63	$158.29	$331.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $72.98 / $125.28 / $608.15	Professional		$72.98	$125.28	$608.15
Midlands Facility/Professional Facility Modifier Low / Median / High Price $145.96 / $247.80 / $340.26	Facility		$145.96	$247.80	$340.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $146.07 / $247.80 / $331.60	Professional		$146.07	$247.80	$331.60
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $898.37 / $898.37 / $898.37	Facility		$898.37	$898.37	$898.37
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $121.63 / $121.63 / $217.11	Professional		$121.63	$121.63	$217.11
United Facility/Professional Professional Modifier Low / Median / High Price $72.98 / $72.98 / $294.61	Professional		$72.98	$72.98	$294.61
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $121.63 / $121.63 / $121.63	Professional		$121.63	$121.63	$121.63