Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.35 / $164.33 / $254.07	Facility		$125.35	$164.33	$254.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.77 / $154.03 / $497.00	Professional		$106.77	$154.03	$497.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.89 / $222.19 / $358.74	Professional		$120.89	$222.19	$358.74
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $109.68 / $193.94 / $342.12	Professional		$109.68	$193.94	$342.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $117.51 / $185.88 / $274.05	Facility		$117.51	$185.88	$274.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $148.80 / $247.72 / $944.96	Professional		$148.80	$247.72	$944.96
Midlands Facility/Professional Facility Modifier Low / Median / High Price $153.51 / $221.12 / $323.01	Facility		$153.51	$221.12	$323.01
Midlands Facility/Professional Professional Modifier Low / Median / High Price $153.51 / $227.18 / $304.16	Professional		$153.51	$227.18	$304.16
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $141.38 / $141.38 / $866.88	Facility		$141.38	$141.38	$866.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $135.80 / $204.01 / $271.68	Professional		$135.80	$204.01	$271.68
United Facility/Professional Professional Modifier Low / Median / High Price $146.75 / $198.85 / $340.75	Professional		$146.75	$198.85	$340.75
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 $165.00 / $201.80 / $257.10	Professional		$165.00	$201.80	$257.10