Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.13 / $184.31 / $390.14	Facility		$102.13	$184.31	$390.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.53 / $82.42 / $91.90	Professional		$62.53	$82.42	$91.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.69 / $172.34 / $215.42	Professional		$113.69	$172.34	$215.42
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $94.74 / $156.32 / $317.02	Professional		$94.74	$156.32	$317.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $94.74 / $123.16 / $257.48	Facility		$94.74	$123.16	$257.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $56.84 / $97.58 / $473.70	Professional		$56.84	$97.58	$473.70
Midlands Facility/Professional Facility Modifier Low / Median / High Price $113.69 / $187.06 / $257.48	Facility		$113.69	$187.06	$257.48
Midlands Facility/Professional Professional Modifier Low / Median / High Price $113.69 / $187.06 / $263.02	Professional		$113.69	$187.06	$263.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $94.74 / $94.74 / $169.11	Professional		$94.74	$94.74	$169.11
United Facility/Professional Professional Modifier Low / Median / High Price $56.84 / $56.84 / $188.72	Professional		$56.84	$56.84	$188.72
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $94.74 / $94.74 / $94.74	Professional		$94.74	$94.74	$94.74