Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $303.80 / $303.80 / $303.80	Facility		$303.80	$303.80	$303.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.24 / $59.25 / $215.00	Professional		$45.24	$59.25	$215.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.68 / $113.98 / $132.11	Professional		$52.68	$113.98	$132.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $49.83 / $72.93 / $238.05	Professional		$49.83	$72.93	$238.05
Medica Facility/Professional Facility Modifier Low / Median / High Price $49.60 / $80.44 / $128.51	Facility		$49.60	$80.44	$128.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $70.09 / $119.63 / $310.89	Professional		$70.09	$119.63	$310.89
Midlands Facility/Professional Facility Modifier Low / Median / High Price $93.54 / $113.98 / $127.92	Facility		$93.54	$113.98	$127.92
Midlands Facility/Professional Professional Modifier Low / Median / High Price $93.54 / $116.33 / $132.11	Professional		$93.54	$116.33	$132.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $45.09 / $79.61 / $95.91	Professional		$45.09	$79.61	$95.91
United Facility/Professional Professional Modifier Low / Median / High Price $56.67 / $91.66 / $134.04	Professional		$56.67	$91.66	$134.04
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $78.05 / $98.80 / $116.20	Professional		$78.05	$98.80	$116.20