Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $269.15 / $426.58	Facility		$109.65	$269.15	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $141.25 / $602.56	Professional		$100.00	$141.25	$602.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $275.42 / $338.84	Professional		$275.42	$275.42	$338.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $251.19 / $316.23	Professional		$141.25	$251.19	$316.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $181.97 / $363.08	Facility		$141.25	$181.97	$363.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $169.82 / $676.08	Professional		$85.11	$169.82	$676.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Professional		$169.82	$169.82	$169.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $154.88 / $251.19	Professional		$138.04	$154.88	$251.19
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 / $87.10 / $363.08	Professional		$85.11	$87.10	$363.08
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Professional		$141.25	$141.25	$141.25