Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $173.78 / $257.04	Facility		$165.96	$173.78	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $169.82 / $398.11	Professional		$87.10	$169.82	$398.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $151.36 / $295.12	Professional		$89.13	$151.36	$295.12
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $165.96 / $281.84	Professional		$89.13	$165.96	$281.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $125.89 / $208.93	Facility		$79.43	$125.89	$208.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $199.53 / $776.25	Professional		$114.82	$199.53	$776.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $190.55 / $295.12	Professional		$125.89	$190.55	$295.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $181.97 / $331.13	Professional		$114.82	$181.97	$331.13
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $295.12	Facility		$54.95	$54.95	$295.12
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $213.80 / $288.40	Professional		$144.54	$213.80	$288.40
United Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $144.54	Facility		$114.82	$114.82	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $131.83 / $229.09	Professional		$91.20	$131.83	$229.09
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 $134.90 / $165.96 / $213.80	Professional		$134.90	$165.96	$213.80