Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.10 / $182.32 / $239.89	Facility		$117.10	$182.32	$239.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.12 / $143.11 / $398.00	Professional		$87.12	$143.11	$398.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.04 / $181.35 / $292.22	Professional		$99.04	$181.35	$292.22
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $89.81 / $154.81 / $263.62	Professional		$89.81	$154.81	$263.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $95.96 / $148.74 / $227.19	Facility		$95.96	$148.74	$227.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $123.42 / $211.58 / $785.23	Professional		$123.42	$211.58	$785.23
Midlands Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $180.51 / $263.67	Facility		$125.89	$180.51	$263.67
Midlands Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $186.46 / $252.40	Professional		$125.89	$186.46	$252.40
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $55.35 / $55.35 / $282.24	Facility		$55.35	$55.35	$282.24
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $142.35 / $169.91 / $226.62	Professional		$142.35	$169.91	$226.62
United Facility/Professional Professional Modifier Low / Median / High Price $121.60 / $162.40 / $282.36	Professional		$121.60	$162.40	$282.36
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 $135.30 / $165.50 / $214.10	Professional		$135.30	$165.50	$214.10