Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $154.88 / $186.21	Facility		$75.86	$154.88	$186.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $83.18 / $144.54	Professional		$67.61	$83.18	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $147.91 / $245.47	Professional		$81.28	$147.91	$245.47
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $141.25 / $316.23	Professional		$81.28	$141.25	$316.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $117.49 / $229.09	Facility		$74.13	$117.49	$229.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $173.78 / $724.44	Professional		$107.15	$173.78	$724.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $190.55 / $295.12	Professional		$138.04	$190.55	$295.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $169.82 / $257.04	Professional		$134.90	$169.82	$257.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $199.53 / $257.04	Professional		$162.18	$199.53	$257.04
United Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $128.82	Facility		$109.65	$109.65	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $123.03 / $199.53	Professional		$91.20	$123.03	$199.53
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $120.23 / $144.54	Professional		$95.50	$120.23	$144.54