Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $122.91 / $122.91 / $122.91	Facility		$122.91	$122.91	$122.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.02 / $105.86 / $135.79	Professional		$87.02	$105.86	$135.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.85 / $143.91 / $279.07	Professional		$92.85	$143.91	$279.07
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $83.96 / $138.10 / $214.87	Professional		$83.96	$138.10	$214.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $104.98 / $151.38 / $275.22	Facility		$104.98	$151.38	$275.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $113.74 / $198.53 / $661.18	Professional		$113.74	$198.53	$661.18
Midlands Facility/Professional Facility Modifier Low / Median / High Price $130.25 / $170.91 / $262.64	Facility		$130.25	$170.91	$262.64
Midlands Facility/Professional Professional Modifier Low / Median / High Price $130.25 / $182.00 / $278.63	Professional		$130.25	$182.00	$278.63
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $134.00 / $197.30 / $281.10	Professional		$134.00	$197.30	$281.10
United Facility/Professional Professional Modifier Low / Median / High Price $109.71 / $170.42 / $278.14	Professional		$109.71	$170.42	$278.14
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $115.42 / $146.10 / $171.90	Professional		$115.42	$146.10	$171.90