Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $96.87 / $175.23 / $175.23	Facility		$96.87	$175.23	$175.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.23 / $93.83 / $102.49	Professional		$92.23	$93.83	$102.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.90 / $136.88 / $227.03	Professional		$86.90	$136.88	$227.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $92.23 / $110.68 / $227.03	Facility		$92.23	$110.68	$227.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $92.03 / $142.82 / $599.65	Professional		$92.03	$142.82	$599.65
Midlands Facility/Professional Facility Modifier Low / Median / High Price $120.53 / $141.68 / $227.03	Facility		$120.53	$141.68	$227.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $87.47 / $141.68 / $227.03	Professional		$87.47	$141.68	$227.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $126.30 / $166.59 / $176.89	Professional		$126.30	$166.59	$176.89
United Facility/Professional Professional Modifier Low / Median / High Price $90.89 / $126.04 / $200.99	Professional		$90.89	$126.04	$200.99
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $109.18 / $138.19 / $138.19	Professional		$109.18	$138.19	$138.19