Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $208.93 / $281.84	Facility		$158.49	$208.93	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $169.82 / $426.58	Professional		$91.20	$169.82	$426.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $158.49 / $323.59	Professional		$93.33	$158.49	$323.59
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $177.83 / $302.00	Professional		$95.50	$177.83	$302.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $134.90 / $229.09	Facility		$85.11	$134.90	$229.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $194.98 / $851.14	Professional		$123.03	$194.98	$851.14
Midlands Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $199.53 / $316.23	Professional		$138.04	$199.53	$316.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $190.55 / $354.81	Professional		$123.03	$190.55	$354.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $234.42 / $309.03	Professional		$151.36	$234.42	$309.03
United Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $158.49	Facility		$120.23	$120.23	$158.49
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $141.25 / $245.47	Professional		$100.00	$141.25	$245.47
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 $141.25 / $173.78 / $229.09	Professional		$141.25	$173.78	$229.09