Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $183.15 / $330.52 / $468.92	Facility		$183.15	$330.52	$468.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.82 / $147.81 / $340.00	Professional		$130.82	$147.81	$340.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $203.88 / $308.77 / $385.97	Professional		$203.88	$308.77	$385.97
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $169.90 / $254.85 / $363.75	Professional		$169.90	$254.85	$363.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $161.41 / $204.05 / $390.77	Facility		$161.41	$204.05	$390.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $77.42 / $169.90 / $500.78	Professional		$77.42	$169.90	$500.78
Midlands Facility/Professional Facility Modifier Low / Median / High Price $203.88 / $237.86 / $372.35	Facility		$203.88	$237.86	$372.35
Midlands Facility/Professional Professional Modifier Low / Median / High Price $203.88 / $255.95 / $372.35	Professional		$203.88	$255.95	$372.35
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $169.90 / $169.90 / $303.27	Professional		$169.90	$169.90	$303.27
United Facility/Professional Professional Modifier Low / Median / High Price $77.42 / $101.94 / $370.38	Professional		$77.42	$101.94	$370.38
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $169.90 / $169.90 / $169.90	Professional		$169.90	$169.90	$169.90