Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $162.18 / $234.42	Facility		$85.11	$162.18	$234.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $131.83 / $398.11	Professional		$81.28	$131.83	$398.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $117.49 / $234.42	Professional		$87.10	$117.49	$234.42
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $165.96 / $380.19	Professional		$95.50	$165.96	$380.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $173.78 / $229.09	Facility		$109.65	$173.78	$229.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $186.21 / $707.95	Professional		$120.23	$186.21	$707.95
Midlands Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $199.53 / $309.03	Professional		$186.21	$199.53	$309.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $186.21 / $199.53	Professional		$186.21	$186.21	$199.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $162.18 / $239.88	Professional		$95.50	$162.18	$239.88
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $144.54 / $263.03	Professional		$112.20	$144.54	$263.03
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $131.83 / $144.54	Professional		$112.20	$131.83	$144.54