Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $155.03 / $197.08 / $262.77	Facility		$155.03	$197.08	$262.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.59 / $94.04 / $427.68	Professional		$65.59	$94.04	$427.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.72 / $118.08 / $235.52	Professional		$77.72	$118.08	$235.52
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $65.30 / $99.63 / $263.73	Professional		$65.30	$99.63	$263.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $74.83 / $117.56 / $194.16	Facility		$74.83	$117.56	$194.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $103.90 / $221.32 / $633.97	Professional		$103.90	$221.32	$633.97
Midlands Facility/Professional Facility Modifier Low / Median / High Price $159.86 / $194.16 / $228.79	Facility		$159.86	$194.16	$228.79
Midlands Facility/Professional Professional Modifier Low / Median / High Price $159.86 / $194.16 / $255.81	Professional		$159.86	$194.16	$255.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $73.13 / $113.18 / $175.76	Professional		$73.13	$113.18	$175.76
United Facility/Professional Professional Modifier Low / Median / High Price $98.20 / $157.04 / $266.97	Professional		$98.20	$157.04	$266.97
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $122.40 / $144.00 / $185.00	Professional		$122.40	$144.00	$185.00