Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Facility		$134.90	$134.90	$134.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $64.57 / $120.23	Professional		$56.23	$64.57	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $125.89 / $173.78	Professional		$66.07	$125.89	$173.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $323.59 / $398.11	Professional		$70.79	$323.59	$398.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $91.20 / $151.36	Facility		$60.26	$91.20	$151.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $117.49 / $467.74	Professional		$75.86	$117.49	$467.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $144.54 / $194.98	Professional		$104.71	$144.54	$194.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $141.25 / $199.53	Professional		$125.89	$141.25	$199.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $147.91 / $186.21	Professional		$141.25	$147.91	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $97.72 / $169.82	Professional		$74.13	$97.72	$169.82
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $144.54 / $144.54	Professional		$114.82	$144.54	$144.54