Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.00 / $196.71 / $275.16	Facility		$109.00	$196.71	$275.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.86 / $87.97 / $650.20	Professional		$77.86	$87.97	$650.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.44 / $184.09 / $230.11	Professional		$121.44	$184.09	$230.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $126.40 / $176.96 / $218.83	Professional		$126.40	$176.96	$218.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $101.12 / $130.47 / $269.99	Facility		$101.12	$130.47	$269.99
Medica Facility/Professional Professional Modifier Low / Median / High Price $60.67 / $101.12 / $326.32	Professional		$60.67	$101.12	$326.32
Midlands Facility/Professional Facility Modifier Low / Median / High Price $121.34 / $185.41 / $224.72	Facility		$121.34	$185.41	$224.72
Midlands Facility/Professional Professional Modifier Low / Median / High Price $121.34 / $185.41 / $221.62	Professional		$121.34	$185.41	$221.62
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $101.12 / $101.12 / $180.50	Professional		$101.12	$101.12	$180.50
United Facility/Professional Professional Modifier Low / Median / High Price $60.67 / $60.67 / $255.73	Professional		$60.67	$60.67	$255.73
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $101.12 / $101.12 / $101.12	Professional		$101.12	$101.12	$101.12