Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $131.83	Facility		$120.23	$120.23	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $95.50 / $309.03	Professional		$81.28	$95.50	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $181.97 / $380.19	Professional		$70.79	$181.97	$380.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $104.71 / $263.03	Professional		$75.86	$104.71	$263.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $120.23 / $208.93	Facility		$81.28	$120.23	$208.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $154.88 / $616.60	Professional		$75.86	$154.88	$616.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $194.98 / $251.19	Professional		$120.23	$194.98	$251.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $218.78 / $257.04	Professional		$218.78	$218.78	$257.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $109.65 / $223.87	Professional		$75.86	$109.65	$223.87
United Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $67.61	Facility		$67.61	$67.61	$67.61
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $134.90 / $239.88	Professional		$77.62	$134.90	$239.88
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $128.82 / $151.36	Professional		$112.20	$128.82	$151.36