Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $103.42 / $142.38 / $220.14	Facility		$103.42	$142.38	$220.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.47 / $145.16 / $415.00	Professional		$88.47	$145.16	$415.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.94 / $183.75 / $304.67	Professional		$99.94	$183.75	$304.67
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $90.49 / $162.97 / $266.57	Professional		$90.49	$162.97	$266.57
Medica Facility/Professional Facility Modifier Low / Median / High Price $96.85 / $153.88 / $236.44	Facility		$96.85	$153.88	$236.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $126.80 / $213.13 / $817.69	Professional		$126.80	$213.13	$817.69
Midlands Facility/Professional Facility Modifier Low / Median / High Price $126.80 / $185.50 / $265.70	Facility		$126.80	$185.50	$265.70
Midlands Facility/Professional Professional Modifier Low / Median / High Price $126.80 / $187.88 / $263.07	Professional		$126.80	$187.88	$263.07
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $68.17 / $68.17 / $68.17	Facility		$68.17	$68.17	$68.17
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $118.66 / $168.70 / $236.05	Professional		$118.66	$168.70	$236.05
United Facility/Professional Professional Modifier Low / Median / High Price $126.58 / $158.22 / $293.92	Professional		$126.58	$158.22	$293.92
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 $136.30 / $166.70 / $223.30	Professional		$136.30	$166.70	$223.30