Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.66 / $165.57 / $368.05	Facility		$66.66	$165.57	$368.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.77 / $136.58 / $432.96	Professional		$73.77	$136.58	$432.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.05 / $173.64 / $217.06	Professional		$115.05	$173.64	$217.06
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $95.80 / $149.71 / $189.99	Professional		$95.80	$149.71	$189.99
Medica Facility/Professional Facility Modifier Low / Median / High Price $95.80 / $130.36 / $267.39	Facility		$95.80	$130.36	$267.39
Medica Facility/Professional Professional Modifier Low / Median / High Price $57.48 / $98.67 / $450.55	Professional		$57.48	$98.67	$450.55
Midlands Facility/Professional Facility Modifier Low / Median / High Price $114.96 / $175.65 / $257.66	Facility		$114.96	$175.65	$257.66
Midlands Facility/Professional Professional Modifier Low / Median / High Price $114.96 / $175.65 / $250.04	Professional		$114.96	$175.65	$250.04
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $313.73 / $1,552.82 / $2,682.14	Facility		$313.73	$1,552.82	$2,682.14
United Facility/Professional Professional Modifier Low / Median / High Price $57.48 / $57.48 / $242.28	Professional		$57.48	$57.48	$242.28
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $95.80 / $95.80 / $95.80	Professional		$95.80	$95.80	$95.80