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 $105.49 / $119.19 / $450.00	Professional		$105.49	$119.19	$450.00
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 / $490.06	Professional		$150.69	$239.75	$490.06
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 / $246.60 / $349.35	Professional		$164.40	$246.60	$349.35
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $146.34 / $146.34 / $146.34	Facility		$146.34	$146.34	$146.34
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 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