Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $263.03 / $389.05	Facility		$109.65	$263.03	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $128.82 / $354.81	Professional		$93.33	$128.82	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $275.42 / $338.84	Professional		$181.97	$275.42	$338.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $257.04 / $371.54	Professional		$151.36	$257.04	$371.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $169.82 / $363.08	Facility		$141.25	$169.82	$363.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $141.25 / $575.44	Professional		$85.11	$141.25	$575.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $181.97	Professional		$169.82	$169.82	$181.97
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $281.84	Facility		$281.84	$281.84	$281.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $154.88 / $302.00	Professional		$141.25	$154.88	$302.00
United Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $141.25 / $331.13	Facility		$141.25	$141.25	$331.13
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $363.08	Professional		$85.11	$85.11	$363.08
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Professional		$141.25	$141.25	$141.25