Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $6.03 / $223.87 / $602.56	Facility		$6.03	$223.87	$602.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $123.03 / $363.08	Professional		$107.15	$123.03	$363.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $275.42 / $346.74	Professional		$263.03	$275.42	$346.74
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $263.03 / $446.68	Professional		$151.36	$263.03	$446.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $190.55 / $389.05	Facility		$144.54	$190.55	$389.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $234.42 / $741.31	Professional		$144.54	$234.42	$741.31
Midlands Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $186.21 / $758.58	Professional		$173.78	$186.21	$758.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $154.88 / $309.03	Professional		$141.25	$154.88	$309.03
United Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $144.54 / $331.13	Facility		$144.54	$144.54	$331.13
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $147.91 / $346.74	Professional		$144.54	$147.91	$346.74
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Professional		$144.54	$144.54	$144.54