Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $161.69 / $291.81 / $408.18	Facility		$161.69	$291.81	$408.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.00 / $130.50 / $145.50	Professional		$99.00	$130.50	$145.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $180.15 / $272.87 / $341.09	Professional		$180.15	$272.87	$341.09
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $165.00 / $262.50 / $437.01	Professional		$165.00	$262.50	$437.01
Medica Facility/Professional Facility Modifier Low / Median / High Price $150.00 / $180.15 / $345.00	Facility		$150.00	$180.15	$345.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $150.00 / $588.79	Professional		$90.00	$150.00	$588.79
Midlands Facility/Professional Facility Modifier Low / Median / High Price $180.00 / $275.04 / $333.35	Facility		$180.00	$275.04	$333.35
Midlands Facility/Professional Professional Modifier Low / Median / High Price $180.00 / $275.04 / $382.50	Professional		$180.00	$275.04	$382.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $150.00 / $267.75	Professional		$150.00	$150.00	$267.75
United Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $90.00 / $327.00	Professional		$90.00	$90.00	$327.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $150.00 / $150.00	Professional		$150.00	$150.00	$150.00