Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Facility		$245.47	$245.47	$245.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $134.90 / $457.09	Professional		$104.71	$134.90	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $223.87 / $316.23	Professional		$120.23	$223.87	$316.23
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $316.23 / $1,000.00	Professional		$125.89	$316.23	$1,000.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $177.83 / $302.00	Facility		$107.15	$177.83	$302.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $204.17 / $1,348.96	Professional		$134.90	$204.17	$1,348.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $263.03 / $346.74	Professional		$190.55	$263.03	$346.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $281.84 / $354.81	Professional		$223.87	$281.84	$354.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $208.93 / $263.03	Professional		$117.49	$208.93	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $169.82 / $295.12	Professional		$131.83	$169.82	$295.12
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $263.03 / $263.03	Professional		$208.93	$263.03	$263.03