Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $100.00 / $234.42	Facility		$63.10	$100.00	$234.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $112.20 / $331.13	Professional		$58.88	$112.20	$331.13
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $60.26 / $60.26 / $60.26	Professional	CQ	$60.26	$60.26	$60.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $64.57 / $112.20	Facility		$50.12	$64.57	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $107.15 / $158.49	Professional		$81.28	$107.15	$158.49
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $131.83 / $213.80	Professional		$93.33	$131.83	$213.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $125.89 / $234.42	Facility		$74.13	$125.89	$234.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $120.23 / $263.03	Professional		$67.61	$120.23	$263.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $151.36 / $173.78	Professional		$125.89	$151.36	$173.78
Midlands Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Midlands Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $173.78	Professional		$120.23	$120.23	$173.78
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $245.47 / $691.83	Facility		$104.71	$245.47	$691.83
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $125.89 / $199.53	Professional		$93.33	$125.89	$199.53
United Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $107.15 / $151.36	Facility		$97.72	$107.15	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $83.18 / $147.91	Professional		$61.66	$83.18	$147.91
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $147.91	Professional		$125.89	$125.89	$147.91