Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.49 / $244.49 / $372.80	Facility		$105.49	$244.49	$372.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.42 / $119.19 / $132.88	Professional		$90.42	$119.19	$132.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.54 / $249.37 / $311.70	Professional		$164.54	$249.37	$311.70
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.69 / $239.75 / $378.91	Professional		$150.69	$239.75	$378.91
Medica Facility/Professional Facility Modifier Low / Median / High Price $130.15 / $164.54 / $315.10	Facility		$130.15	$164.54	$315.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $82.20 / $137.00 / $442.11	Professional		$82.20	$137.00	$442.11
Midlands Facility/Professional Facility Modifier Low / Median / High Price $164.40 / $251.21 / $304.45	Facility		$164.40	$251.21	$304.45
Midlands Facility/Professional Professional Modifier Low / Median / High Price $164.40 / $251.21 / $319.20	Professional		$164.40	$251.21	$319.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $137.00 / $137.00 / $244.54	Professional		$137.00	$137.00	$244.54
United Facility/Professional Professional Modifier Low / Median / High Price $82.20 / $82.20 / $280.51	Professional		$82.20	$82.20	$280.51
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $137.00 / $137.00 / $137.00	Professional		$137.00	$137.00	$137.00