Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.50 / $159.82 / $215.76	Facility		$125.50	$159.82	$215.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.17 / $105.00 / $217.37	Professional		$73.17	$105.00	$217.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.79 / $164.54 / $250.60	Professional		$89.79	$164.54	$250.60
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $85.02 / $154.63 / $363.98	Professional		$85.02	$154.63	$363.98
Medica Facility/Professional Facility Modifier Low / Median / High Price $101.44 / $172.21 / $232.95	Facility		$101.44	$172.21	$232.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $129.72 / $216.99 / $746.21	Professional		$129.72	$216.99	$746.21
Midlands Facility/Professional Facility Modifier Low / Median / High Price $176.10 / $194.00 / $375.14	Facility		$176.10	$194.00	$375.14
Midlands Facility/Professional Professional Modifier Low / Median / High Price $164.54 / $212.58 / $375.14	Professional		$164.54	$212.58	$375.14
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $45.20 / $45.20 / $462.42	Facility		$45.20	$45.20	$462.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $97.07 / $118.36 / $253.67	Professional		$97.07	$118.36	$253.67
United Facility/Professional Professional Modifier Low / Median / High Price $123.83 / $159.33 / $273.83	Professional		$123.83	$159.33	$273.83
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $105.80 / $126.40 / $160.00	Professional		$105.80	$126.40	$160.00