Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.07 / $171.58 / $239.99	Facility		$95.07	$171.58	$239.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.21 / $76.73 / $85.55	Professional		$58.21	$76.73	$85.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.92 / $160.59 / $200.74	Professional		$105.92	$160.59	$200.74
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $97.02 / $154.35 / $236.19	Professional		$97.02	$154.35	$236.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $88.20 / $105.92 / $202.86	Facility		$88.20	$105.92	$202.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.92 / $88.20 / $346.23	Professional		$52.92	$88.20	$346.23
Midlands Facility/Professional Facility Modifier Low / Median / High Price $105.84 / $161.72 / $196.00	Facility		$105.84	$161.72	$196.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $105.84 / $161.72 / $224.91	Professional		$105.84	$161.72	$224.91
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $88.20 / $88.20 / $157.44	Professional		$88.20	$88.20	$157.44
United Facility/Professional Professional Modifier Low / Median / High Price $52.92 / $52.92 / $192.28	Professional		$52.92	$52.92	$192.28
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $88.20 / $88.20 / $88.20	Professional		$88.20	$88.20	$88.20