Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.36 / $242.47 / $339.16	Facility		$134.36	$242.47	$339.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.26 / $108.44 / $120.90	Professional		$82.26	$108.44	$120.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $149.69 / $226.52 / $283.14	Professional		$149.69	$226.52	$283.14
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $137.10 / $218.12 / $440.80	Professional		$137.10	$218.12	$440.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $124.64 / $160.84 / $332.79	Facility		$124.64	$160.84	$332.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $45.59 / $124.64 / $344.01	Professional		$45.59	$124.64	$344.01
Midlands Facility/Professional Facility Modifier Low / Median / High Price $149.57 / $166.29 / $273.16	Facility		$149.57	$166.29	$273.16
Midlands Facility/Professional Professional Modifier Low / Median / High Price $149.57 / $166.29 / $273.16	Professional		$149.57	$166.29	$273.16
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $124.64 / $124.64 / $222.48	Professional		$124.64	$124.64	$222.48
United Facility/Professional Professional Modifier Low / Median / High Price $45.59 / $74.78 / $216.66	Professional		$45.59	$74.78	$216.66
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $124.64 / $124.64 / $124.64	Professional		$124.64	$124.64	$124.64