Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $97.72 / $128.82	Facility		$83.18	$97.72	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $87.10 / $190.55	Professional		$67.61	$87.10	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $102.33 / $229.09	Professional		$69.18	$102.33	$229.09
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $97.72 / $251.19	Professional		$66.07	$97.72	$251.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $123.03 / $208.93	Facility		$77.62	$123.03	$208.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $186.21 / $588.84	Professional		$95.50	$186.21	$588.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $204.17 / $239.88	Professional		$169.82	$204.17	$239.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $165.96 / $234.42	Professional		$93.33	$165.96	$234.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $104.71 / $199.53	Professional		$74.13	$104.71	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $131.83 / $234.42	Professional		$89.13	$131.83	$234.42
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $147.91 / $173.78	Professional		$128.82	$147.91	$173.78