Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.64 / $212.30 / $463.74	Facility		$117.64	$212.30	$463.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.03 / $94.94 / $159.65	Professional		$84.03	$94.94	$159.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.07 / $197.80 / $247.25	Professional		$131.07	$197.80	$247.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $109.13 / $180.06 / $269.02	Professional		$109.13	$180.06	$269.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $109.13 / $141.87 / $306.04	Facility		$109.13	$141.87	$306.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $65.48 / $112.40 / $545.65	Professional		$65.48	$112.40	$545.65
Midlands Facility/Professional Facility Modifier Low / Median / High Price $130.96 / $222.34 / $306.04	Facility		$130.96	$222.34	$306.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $131.07 / $222.34 / $312.64	Professional		$131.07	$222.34	$312.64
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $109.13 / $109.13 / $194.80	Professional		$109.13	$109.13	$194.80
United Facility/Professional Professional Modifier Low / Median / High Price $65.48 / $65.48 / $264.35	Professional		$65.48	$65.48	$264.35
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $109.13 / $109.13 / $109.13	Professional		$109.13	$109.13	$109.13