Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $134.90	Facility		$120.23	$120.23	$134.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $107.15 / $354.81	Professional		$70.79	$107.15	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $162.18 / $263.03	Professional		$81.28	$162.18	$263.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $181.97 / $354.81	Professional		$109.65	$181.97	$354.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $162.18 / $426.58	Facility		$95.50	$162.18	$426.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $181.97 / $1,174.90	Professional		$85.11	$181.97	$1,174.90
Midlands Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $162.18 / $257.04	Professional		$97.72	$162.18	$257.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $169.82 / $181.97	Professional		$162.18	$169.82	$181.97
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $138.04 / $173.78	Professional		$79.43	$138.04	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $89.13 / $302.00	Professional		$85.11	$89.13	$302.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $169.82 / $169.82	Professional		$144.54	$169.82	$169.82