Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.22 / $102.22 / $102.22	Facility		$102.22	$102.22	$102.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.63 / $148.97 / $278.48	Professional		$64.63	$148.97	$278.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.16 / $126.55 / $158.18	Professional		$83.16	$126.55	$158.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $66.79 / $95.24 / $578.77	Professional		$66.79	$95.24	$578.77
Medica Facility/Professional Facility Modifier Low / Median / High Price $65.13 / $122.00 / $166.79	Facility		$65.13	$122.00	$166.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $79.78 / $117.65 / $649.20	Professional		$79.78	$117.65	$649.20
Midlands Facility/Professional Facility Modifier Low / Median / High Price $103.83 / $143.81 / $169.34	Facility		$103.83	$143.81	$169.34
Midlands Facility/Professional Professional Modifier Low / Median / High Price $103.83 / $139.25 / $191.70	Professional		$103.83	$139.25	$191.70
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $65.81 / $117.72 / $135.69	Professional		$65.81	$117.72	$135.69
United Facility/Professional Professional Modifier Low / Median / High Price $76.16 / $92.11 / $168.41	Professional		$76.16	$92.11	$168.41
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $113.52 / $122.20 / $148.10	Professional		$113.52	$122.20	$148.10