Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.93 / $153.24 / $260.00	Facility		$114.93	$153.24	$260.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.93 / $149.84 / $250.81	Professional		$114.93	$149.84	$250.81
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $171.41 / $171.41 / $171.41	Professional	25	$171.41	$171.41	$171.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $201.32 / $201.32 / $201.32	Facility		$201.32	$201.32	$201.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $185.95 / $378.11	Professional		$85.00	$185.95	$378.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $125.87 / $172.38 / $253.15	Professional		$125.87	$172.38	$253.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $149.61 / $182.05 / $276.83	Facility		$149.61	$182.05	$276.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $133.07 / $231.12 / $1,103.45	Professional		$133.07	$231.12	$1,103.45
Midlands Facility/Professional Facility Modifier Low / Median / High Price $172.12 / $200.86 / $320.62	Facility		$172.12	$200.86	$320.62
Midlands Facility/Professional Professional Modifier Low / Median / High Price $163.46 / $218.96 / $437.09	Professional		$163.46	$218.96	$437.09
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $785.17 / $785.17 / $785.17	Facility		$785.17	$785.17	$785.17
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $129.47 / $171.47 / $296.68	Professional		$129.47	$171.47	$296.68
United Facility/Professional Professional Modifier Low / Median / High Price $126.70 / $191.23 / $370.71	Professional		$126.70	$191.23	$370.71
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $160.19 / $191.89 / $242.90	Professional		$160.19	$191.89	$242.90