Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.60 / $141.60 / $1,757.88	Facility		$141.60	$141.60	$1,757.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.28 / $113.28 / $141.60	Professional		$113.28	$113.28	$141.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.13 / $124.71 / $143.91	Professional		$115.13	$124.71	$143.91
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $247.10 / $271.58	Professional		$150.00	$247.10	$271.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $1.00 / $97.42 / $141.72	Facility		$1.00	$97.42	$141.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $118.00 / $118.00 / $121.54	Professional		$118.00	$118.00	$121.54
Midlands Facility/Professional Facility Modifier Low / Median / High Price $131.77 / $161.06 / $233.38	Facility		$131.77	$161.06	$233.38
Midlands Facility/Professional Professional Modifier Low / Median / High Price $141.72 / $141.72 / $141.72	Professional		$141.72	$141.72	$141.72
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,622.90 / $1,622.90 / $1,622.90	Facility		$1,622.90	$1,622.90	$1,622.90
United Facility/Professional Professional Modifier Low / Median / High Price $118.00 / $118.00 / $120.36	Professional		$118.00	$118.00	$120.36
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $118.00 / $118.00 / $118.00	Facility		$118.00	$118.00	$118.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $118.00 / $118.00 / $118.00	Professional		$118.00	$118.00	$118.00