Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Facility		$173.78	$173.78	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $83.18 / $125.89	Professional		$57.54	$83.18	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $154.88 / $489.78	Professional		$134.90	$154.88	$489.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $269.15 / $446.68	Professional		$208.93	$269.15	$446.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $85.11 / $162.18	Facility		$72.44	$85.11	$162.18
Medica Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $446.68 / $446.68	Professional		$154.88	$446.68	$446.68
Midlands Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Professional		$154.88	$154.88	$154.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $346.74 / $346.74	Professional		$154.88	$346.74	$346.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $251.19	Professional		$208.93	$208.93	$251.19
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Professional		$151.36	$151.36	$151.36