Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.94 / $146.57 / $226.70	Facility		$107.94	$146.57	$226.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.67 / $126.86 / $370.48	Professional		$80.67	$126.86	$370.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.99 / $190.96 / $313.68	Professional		$103.99	$190.96	$313.68
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $94.45 / $164.09 / $273.27	Professional		$94.45	$164.09	$273.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $100.78 / $160.25 / $243.71	Facility		$100.78	$160.25	$243.71
Medica Facility/Professional Professional Modifier Low / Median / High Price $130.60 / $220.48 / $842.92	Professional		$130.60	$220.48	$842.92
Midlands Facility/Professional Facility Modifier Low / Median / High Price $132.22 / $190.17 / $276.91	Facility		$132.22	$190.17	$276.91
Midlands Facility/Professional Professional Modifier Low / Median / High Price $132.22 / $195.81 / $270.82	Professional		$132.22	$195.81	$270.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $114.73 / $175.77 / $242.47	Professional		$114.73	$175.77	$242.47
United Facility/Professional Professional Modifier Low / Median / High Price $128.55 / $163.25 / $303.25	Professional		$128.55	$163.25	$303.25
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 $142.10 / $173.90 / $229.60	Professional		$142.10	$173.90	$229.60