Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $134.90 / $165.96	Facility		$79.43	$134.90	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $107.15 / $398.11	Professional		$77.62	$107.15	$398.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $162.18 / $204.17	Professional		$95.50	$162.18	$204.17
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $144.54 / $323.59	Professional		$81.28	$144.54	$323.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $147.91 / $208.93	Facility		$77.62	$147.91	$208.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $181.97 / $676.08	Professional		$117.49	$181.97	$676.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $173.78 / $275.42	Professional		$128.82	$173.78	$275.42
Midlands Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $223.87 / $223.87	Professional		$169.82	$223.87	$223.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $204.17 / $234.42	Professional		$104.71	$204.17	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $134.90 / $239.88	Professional		$109.65	$134.90	$239.88
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $117.49 / $128.82	Professional		$100.00	$117.49	$128.82