Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.50 / $130.49 / $201.15	Facility		$91.50	$130.49	$201.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.04 / $111.12 / $330.88	Professional		$70.04	$111.12	$330.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.21 / $163.21 / $279.58	Professional		$88.21	$163.21	$279.58
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $80.06 / $145.16 / $242.46	Professional		$80.06	$145.16	$242.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $85.81 / $138.24 / $215.05	Facility		$85.81	$138.24	$215.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $115.15 / $195.06 / $743.11	Professional		$115.15	$195.06	$743.11
Midlands Facility/Professional Facility Modifier Low / Median / High Price $111.86 / $169.30 / $241.26	Facility		$111.86	$169.30	$241.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $111.86 / $168.10 / $241.26	Professional		$111.86	$168.10	$241.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $108.74 / $150.06 / $215.04	Professional		$108.74	$150.06	$215.04
United Facility/Professional Professional Modifier Low / Median / High Price $115.39 / $156.05 / $267.94	Professional		$115.39	$156.05	$267.94
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $55.00	Facility		$55.00	$55.00	$55.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $120.20 / $147.10 / $204.40	Professional		$120.20	$147.10	$204.40