Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.74 / $121.10 / $196.33	Facility		$63.74	$121.10	$196.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.51 / $95.02 / $329.00	Professional		$59.51	$95.02	$329.00
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $146.07 / $146.07 / $146.07	Professional	CQ	$146.07	$146.07	$146.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $65.00 / $113.10	Facility		$50.00	$65.00	$113.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.06 / $107.08 / $153.25	Professional		$81.06	$107.08	$153.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $102.55 / $128.46 / $204.04	Professional		$102.55	$128.46	$204.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $63.74 / $125.45 / $240.03	Facility		$63.74	$125.45	$240.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $68.04 / $82.70 / $232.29	Professional		$68.04	$82.70	$232.29
Midlands Facility/Professional Facility Modifier Low / Median / High Price $113.10 / $141.25 / $201.19	Facility		$113.10	$141.25	$201.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $104.48 / $151.19 / $213.27	Professional		$104.48	$151.19	$213.27
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $193.12 / $375.90 / $1,052.52	Facility		$193.12	$375.90	$1,052.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $94.04 / $128.68 / $178.02	Professional		$94.04	$128.68	$178.02
United Facility/Professional Professional Modifier Low / Median / High Price $67.43 / $82.70 / $141.59	Professional		$67.43	$82.70	$141.59
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $126.20 / $126.20 / $148.50	Professional		$126.20	$126.20	$148.50