Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.75 / $237.77 / $519.35	Facility		$131.75	$237.77	$519.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.11 / $106.33 / $294.93	Professional		$94.11	$106.33	$294.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.79 / $221.95 / $277.44	Professional		$146.79	$221.95	$277.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $122.22 / $183.33 / $344.81	Professional		$122.22	$183.33	$344.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $122.22 / $158.88 / $342.77	Facility		$122.22	$158.88	$342.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $73.33 / $125.89 / $611.10	Professional		$73.33	$125.89	$611.10
Midlands Facility/Professional Facility Modifier Low / Median / High Price $146.66 / $249.00 / $342.77	Facility		$146.66	$249.00	$342.77
Midlands Facility/Professional Professional Modifier Low / Median / High Price $146.79 / $249.00 / $350.15	Professional		$146.79	$249.00	$350.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $122.22 / $122.22 / $218.16	Professional		$122.22	$122.22	$218.16
United Facility/Professional Professional Modifier Low / Median / High Price $73.33 / $73.33 / $296.04	Professional		$73.33	$73.33	$296.04
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $122.22 / $122.22 / $122.22	Professional		$122.22	$122.22	$122.22