Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.56 / $115.36 / $166.53	Facility		$73.56	$115.36	$166.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.89 / $99.33 / $312.00	Professional		$56.89	$99.33	$312.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.34 / $131.40 / $231.42	Professional		$70.34	$131.40	$231.42
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $64.37 / $116.90 / $207.11	Professional		$64.37	$116.90	$207.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $68.06 / $111.37 / $176.96	Facility		$68.06	$111.37	$176.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $90.69 / $163.95 / $618.82	Professional		$90.69	$163.95	$618.82
Midlands Facility/Professional Facility Modifier Low / Median / High Price $89.67 / $133.13 / $199.66	Facility		$89.67	$133.13	$199.66
Midlands Facility/Professional Professional Modifier Low / Median / High Price $89.67 / $134.69 / $199.66	Professional		$89.67	$134.69	$199.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $109.42 / $119.70 / $176.72	Professional		$109.42	$119.70	$176.72
United Facility/Professional Professional Modifier Low / Median / High Price $92.04 / $119.67 / $221.33	Professional		$92.04	$119.67	$221.33
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 $96.40 / $117.90 / $168.30	Professional		$96.40	$117.90	$168.30