Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.25 / $196.28 / $196.28	Facility		$67.25	$196.28	$196.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.26 / $85.31 / $299.77	Professional		$70.26	$85.31	$299.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.95 / $146.56 / $279.85	Professional		$79.95	$146.56	$279.85
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $73.98 / $100.22 / $258.69	Professional		$73.98	$100.22	$258.69
Medica Facility/Professional Facility Modifier Low / Median / High Price $79.55 / $135.22 / $182.63	Facility		$79.55	$135.22	$182.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $95.41 / $144.30 / $468.55	Professional		$95.41	$144.30	$468.55
Midlands Facility/Professional Facility Modifier Low / Median / High Price $123.55 / $145.11 / $182.63	Facility		$123.55	$145.11	$182.63
Midlands Facility/Professional Professional Modifier Low / Median / High Price $95.41 / $145.34 / $200.60	Professional		$95.41	$145.34	$200.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $72.02 / $128.56 / $144.44	Professional		$72.02	$128.56	$144.44
United Facility/Professional Professional Modifier Low / Median / High Price $78.04 / $120.94 / $205.60	Professional		$78.04	$120.94	$205.60
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $87.06 / $110.20 / $129.60	Professional		$87.06	$110.20	$129.60