Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $158.49 / $218.78	Facility		$79.43	$158.49	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $123.03 / $309.03	Professional		$77.62	$123.03	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $213.80 / $263.03	Professional		$125.89	$213.80	$263.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $169.82 / $309.03	Professional		$109.65	$169.82	$309.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $165.96 / $234.42	Facility		$104.71	$165.96	$234.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $181.97 / $707.95	Professional		$107.15	$181.97	$707.95
Midlands Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $199.53 / $245.47	Professional		$162.18	$199.53	$245.47
Midlands Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $234.42	Professional		$208.93	$208.93	$234.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $190.55 / $245.47	Professional		$109.65	$190.55	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $120.23 / $234.42	Professional		$104.71	$120.23	$234.42
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $181.97 / $199.53	Professional		$154.88	$181.97	$199.53