Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $94.51 / $147.75 / $198.36	Facility		$94.51	$147.75	$198.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.34 / $141.06 / $380.00	Professional		$81.34	$141.06	$380.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.38 / $168.00 / $274.79	Professional		$91.38	$168.00	$274.79
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $82.70 / $143.83 / $246.07	Professional		$82.70	$143.83	$246.07
Medica Facility/Professional Facility Modifier Low / Median / High Price $88.47 / $138.28 / $212.71	Facility		$88.47	$138.28	$212.71
Medica Facility/Professional Professional Modifier Low / Median / High Price $113.85 / $198.80 / $732.11	Professional		$113.85	$198.80	$732.11
Midlands Facility/Professional Facility Modifier Low / Median / High Price $115.93 / $164.40 / $243.51	Facility		$115.93	$164.40	$243.51
Midlands Facility/Professional Professional Modifier Low / Median / High Price $115.93 / $172.20 / $237.30	Professional		$115.93	$172.20	$237.30
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $33.29 / $33.29 / $122.85	Facility		$33.29	$33.29	$122.85
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $133.88 / $156.49 / $213.18	Professional		$133.88	$156.49	$213.18
United Facility/Professional Professional Modifier Low / Median / High Price $113.41 / $152.47 / $265.29	Professional		$113.41	$152.47	$265.29
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 $124.60 / $152.40 / $201.50	Professional		$124.60	$152.40	$201.50