Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $177.83 / $239.88	Facility		$134.90	$177.83	$239.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $144.54 / $323.59	Professional		$77.62	$144.54	$323.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $138.04 / $275.42	Professional		$79.43	$138.04	$275.42
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $151.36 / $257.04	Professional		$79.43	$151.36	$257.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $112.20 / $190.55	Facility		$69.18	$112.20	$190.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $169.82 / $724.44	Professional		$104.71	$169.82	$724.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $169.82 / $269.15	Professional		$112.20	$169.82	$269.15
Midlands Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $162.18 / $302.00	Professional		$104.71	$162.18	$302.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $199.53 / $263.03	Professional		$131.83	$199.53	$263.03
United Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $102.33 / $134.90	Facility		$102.33	$102.33	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $120.23 / $208.93	Professional		$81.28	$120.23	$208.93
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $147.91 / $194.98	Professional		$120.23	$147.91	$194.98