Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $233.64 / $292.00 / $494.00	Facility		$233.64	$292.00	$494.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.12 / $125.39 / $283.29	Professional		$101.12	$125.39	$283.29
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $134.60 / $140.08 / $400.00	Professional	25	$134.60	$140.08	$400.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $122.42 / $122.42 / $122.42	Professional	52	$122.42	$122.42	$122.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.36 / $181.41 / $304.12	Professional		$116.36	$181.41	$304.12
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $105.03 / $123.56 / $298.39	Professional		$105.03	$123.56	$298.39
Medica Facility/Professional Facility Modifier Low / Median / High Price $114.90 / $189.71 / $267.04	Facility		$114.90	$189.71	$267.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $117.29 / $181.25 / $818.99	Professional		$117.29	$181.25	$818.99
Midlands Facility/Professional Facility Modifier Low / Median / High Price $162.01 / $189.71 / $304.12	Facility		$162.01	$189.71	$304.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $153.80 / $189.71 / $304.12	Professional		$153.80	$189.71	$304.12
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $124.84 / $218.77 / $243.80	Professional		$124.84	$218.77	$243.80
United Facility/Professional Professional Modifier Low / Median / High Price $115.34 / $150.60 / $255.07	Professional		$115.34	$150.60	$255.07
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $146.22 / $185.10 / $185.10	Professional		$146.22	$185.10	$185.10