Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $363.08 / $537.03	Facility		$147.91	$363.08	$537.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $162.18 / $245.47	Professional		$134.90	$162.18	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $371.54 / $457.09	Professional		$251.19	$371.54	$457.09
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $489.78 / $562.34	Professional		$213.80	$489.78	$562.34
Medica Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $234.42 / $489.78	Facility		$194.98	$234.42	$489.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $194.98 / $776.25	Professional		$114.82	$194.98	$776.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $251.19	Professional		$234.42	$234.42	$251.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $208.93 / $407.38	Professional		$194.98	$208.93	$407.38
United Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $446.68	Facility		$194.98	$194.98	$446.68
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $489.78	Professional		$114.82	$114.82	$489.78
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Professional		$194.98	$194.98	$194.98