Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $147.91 / $309.03	Professional		$123.03	$147.91	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $288.40 / $354.81	Professional		$147.91	$288.40	$354.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $204.17 / $467.74	Professional		$128.82	$204.17	$467.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $263.03 / $660.69	Facility		$138.04	$263.03	$660.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $275.42 / $870.96	Professional		$151.36	$275.42	$870.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $316.23 / $363.08	Professional		$269.15	$316.23	$363.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $302.00 / $363.08	Professional		$263.03	$302.00	$363.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $213.80 / $275.42	Professional		$117.49	$213.80	$275.42
United Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $537.03 / $707.95	Facility		$309.03	$537.03	$707.95
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $223.87 / $371.54	Professional		$144.54	$223.87	$371.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $257.04 / $302.00	Professional		$204.17	$257.04	$302.00