Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $163.03 / $163.03 / $220.62	Facility		$163.03	$163.03	$220.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.29 / $116.12 / $330.88	Professional		$74.29	$116.12	$330.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.94 / $162.13 / $268.80	Professional		$87.94	$162.13	$268.80
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $80.06 / $139.43 / $241.00	Professional		$80.06	$139.43	$241.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $85.81 / $137.31 / $207.75	Facility		$85.81	$137.31	$207.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $111.46 / $193.68 / $717.08	Professional		$111.46	$193.68	$717.08
Midlands Facility/Professional Facility Modifier Low / Median / High Price $111.86 / $159.86 / $236.61	Facility		$111.86	$159.86	$236.61
Midlands Facility/Professional Professional Modifier Low / Median / High Price $111.86 / $167.29 / $232.03	Professional		$111.86	$167.29	$232.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $130.38 / $150.06 / $206.19	Professional		$130.38	$150.06	$206.19
United Facility/Professional Professional Modifier Low / Median / High Price $111.46 / $147.56 / $258.81	Professional		$111.46	$147.56	$258.81
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 $120.20 / $147.10 / $195.80	Professional		$120.20	$147.10	$195.80