Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $141.25 / $199.53	Facility		$120.23	$141.25	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $104.71 / $309.03	Professional		$66.07	$104.71	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $158.49 / $245.47	Professional		$52.48	$158.49	$245.47
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $151.36 / $316.23	Professional		$77.62	$151.36	$316.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $114.82 / $234.42	Facility		$70.79	$114.82	$234.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $186.21 / $602.56	Professional		$95.50	$186.21	$602.56
Midlands Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $169.82 / $251.19	Professional		$95.50	$169.82	$251.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $165.96 / $194.98	Professional		$144.54	$165.96	$194.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $123.03 / $194.98	Professional		$69.18	$123.03	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $97.72 / $223.87	Professional		$83.18	$97.72	$223.87
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $169.82 / $204.17	Professional		$144.54	$169.82	$204.17