Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $147.69 / $266.52 / $372.80	Facility		$147.69	$266.52	$372.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.42 / $119.19 / $132.88	Professional		$90.42	$119.19	$132.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.54 / $249.37 / $311.70	Professional		$164.54	$249.37	$311.70
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.69 / $239.75 / $378.91	Professional		$150.69	$239.75	$378.91
Medica Facility/Professional Facility Modifier Low / Median / High Price $136.63 / $164.54 / $365.79	Facility		$136.63	$164.54	$365.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $82.20 / $137.00 / $538.98	Professional		$82.20	$137.00	$538.98
Midlands Facility/Professional Facility Modifier Low / Median / High Price $164.40 / $251.21 / $397.98	Facility		$164.40	$251.21	$397.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $164.40 / $251.21 / $349.35	Professional		$164.40	$251.21	$349.35
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $137.00 / $137.00 / $244.54	Professional		$137.00	$137.00	$244.54
United Facility/Professional Facility Modifier Low / Median / High Price $137.00 / $137.00 / $315.10	Facility		$137.00	$137.00	$315.10
United Facility/Professional Professional Modifier Low / Median / High Price $82.20 / $82.20 / $298.66	Professional		$82.20	$82.20	$298.66
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $137.00 / $137.00 / $137.00	Professional		$137.00	$137.00	$137.00