Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $102.33 / $288.40	Facility		$74.13	$102.33	$288.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $104.71 / $302.00	Professional		$95.50	$104.71	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $199.53 / $204.17	Professional		$162.18	$199.53	$204.17
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $223.87 / $263.03	Professional		$141.25	$223.87	$263.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $169.82 / $346.74	Facility		$128.82	$169.82	$346.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $107.15 / $281.84	Professional		$107.15	$107.15	$281.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $199.53 / $346.74	Professional		$134.90	$199.53	$346.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $186.21 / $346.74	Professional		$186.21	$186.21	$346.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $281.84 / $338.84	Professional		$251.19	$281.84	$338.84
United Facility/Professional Facility Modifier Low / Median / High Price $0.11 / $0.11 / $186.21	Facility		$0.11	$0.11	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $107.15 / $128.82	Professional		$107.15	$107.15	$128.82
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $114.82 / $114.82	Professional		$91.20	$114.82	$114.82