Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.94 / $107.94 / $147.28	Facility		$107.94	$107.94	$147.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.95 / $136.08 / $426.00	Professional		$89.95	$136.08	$426.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.12 / $190.96 / $314.44	Professional		$104.12	$190.96	$314.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $94.45 / $164.93 / $275.98	Professional		$94.45	$164.93	$275.98
Medica Facility/Professional Facility Modifier Low / Median / High Price $100.78 / $163.85 / $244.30	Facility		$100.78	$163.85	$244.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $132.22 / $221.45 / $845.09	Professional		$132.22	$221.45	$845.09
Midlands Facility/Professional Facility Modifier Low / Median / High Price $132.22 / $190.17 / $276.91	Facility		$132.22	$190.17	$276.91
Midlands Facility/Professional Professional Modifier Low / Median / High Price $132.22 / $195.81 / $271.48	Professional		$132.22	$195.81	$271.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $153.41 / $178.09 / $243.65	Professional		$153.41	$178.09	$243.65
United Facility/Professional Professional Modifier Low / Median / High Price $132.00 / $163.08 / $303.25	Professional		$132.00	$163.08	$303.25
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 $142.10 / $173.90 / $230.70	Professional		$142.10	$173.90	$230.70