Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3.96 / $211.56 / $527.50	Facility		$3.96	$211.56	$527.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.44 / $125.81 / $140.27	Professional		$95.44	$125.81	$140.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.67 / $262.43 / $328.03	Professional		$173.67	$262.43	$328.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $144.61 / $253.07 / $448.38	Professional		$144.61	$253.07	$448.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $144.61 / $212.53 / $453.35	Facility		$144.61	$212.53	$453.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $144.61 / $187.99 / $670.82	Professional		$144.61	$187.99	$670.82
Midlands Facility/Professional Facility Modifier Low / Median / High Price $186.61 / $265.17 / $453.35	Facility		$186.61	$265.17	$453.35
Midlands Facility/Professional Professional Modifier Low / Median / High Price $186.61 / $276.20 / $377.43	Professional		$186.61	$276.20	$377.43
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $140.71 / $144.61 / $258.13	Professional		$140.71	$144.61	$258.13
United Facility/Professional Professional Modifier Low / Median / High Price $144.61 / $144.61 / $289.22	Professional		$144.61	$144.61	$289.22
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $144.61 / $144.61 / $144.61	Professional		$144.61	$144.61	$144.61