Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $144.07 / $144.07 / $202.29	Facility		$144.07	$144.07	$202.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.20 / $106.47 / $304.48	Professional		$66.20	$106.47	$304.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.08 / $143.90 / $246.40	Professional		$78.08	$143.90	$246.40
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $70.48 / $125.80 / $219.99	Professional		$70.48	$125.80	$219.99
Medica Facility/Professional Facility Modifier Low / Median / High Price $75.83 / $122.88 / $189.60	Facility		$75.83	$122.88	$189.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $100.49 / $176.27 / $657.47	Professional		$100.49	$176.27	$657.47
Midlands Facility/Professional Facility Modifier Low / Median / High Price $98.27 / $141.74 / $212.67	Facility		$98.27	$141.74	$212.67
Midlands Facility/Professional Professional Modifier Low / Median / High Price $98.27 / $147.50 / $212.67	Professional		$98.27	$147.50	$212.67
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $119.35 / $131.38 / $188.19	Professional		$119.35	$131.38	$188.19
United Facility/Professional Professional Modifier Low / Median / High Price $101.64 / $135.79 / $236.01	Professional		$101.64	$135.79	$236.01
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 $105.60 / $129.19 / $179.20	Professional		$105.60	$129.19	$179.20