Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $181.97 / $275.42	Facility		$72.44	$181.97	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $81.28 / $141.25	Professional		$66.07	$81.28	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $181.97 / $229.09	Professional		$123.03	$181.97	$229.09
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $165.96 / $316.23	Professional		$95.50	$165.96	$316.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $114.82 / $251.19	Facility		$95.50	$114.82	$251.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $114.82 / $478.63	Professional		$56.23	$114.82	$478.63
Midlands Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $123.03	Professional		$114.82	$114.82	$123.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $102.33 / $204.17	Professional		$95.50	$102.33	$204.17
United Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $218.78	Facility		$95.50	$95.50	$218.78
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $58.88 / $257.04	Professional		$56.23	$58.88	$257.04
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Professional		$95.50	$95.50	$95.50