Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $138.04 / $389.05	Facility		$57.54	$138.04	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $69.18 / $186.21	Professional		$54.95	$69.18	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $141.25 / $177.83	Professional		$95.50	$141.25	$177.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $134.90 / $199.53	Professional		$81.28	$134.90	$199.53
Medica Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $89.13 / $199.53	Facility		$74.13	$89.13	$199.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $89.13 / $371.54	Professional		$44.67	$89.13	$371.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $95.50	Professional		$89.13	$89.13	$95.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $81.28 / $158.49	Professional		$74.13	$81.28	$158.49
United Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $169.82	Facility		$74.13	$74.13	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $45.71 / $204.17	Professional		$44.67	$45.71	$204.17
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Professional		$74.13	$74.13	$74.13