Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.36 / $107.36 / $156.22	Facility		$107.36	$107.36	$156.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $68.20 / $172.95	Professional		$68.20	$68.20	$172.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.64 / $68.22 / $218.79	Professional		$60.64	$68.22	$218.79
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $109.50 / $526.89	Professional		$68.20	$109.50	$526.89
Medica Facility/Professional Facility Modifier Low / Median / High Price $71.65 / $107.36 / $288.00	Facility		$71.65	$107.36	$288.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $71.65 / $79.76 / $1,771.57	Professional		$71.65	$79.76	$1,771.57
Midlands Facility/Professional Facility Modifier Low / Median / High Price $71.43 / $241.47 / $336.60	Facility		$71.43	$241.47	$336.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $71.43 / $107.47 / $252.45	Professional		$71.43	$107.47	$252.45
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $81.41 / $136.85 / $145.60	Professional		$81.41	$136.85	$145.60
United Facility/Professional Facility Modifier Low / Median / High Price $98.22 / $98.22 / $98.22	Facility		$98.22	$98.22	$98.22
United Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $70.25 / $81.16	Professional		$68.20	$70.25	$81.16
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $78.41 / $78.41 / $78.41	Facility		$78.41	$78.41	$78.41
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $61.94 / $78.41 / $78.41	Professional		$61.94	$78.41	$78.41