Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $139.34 / $139.34 / $305.07	Facility		$139.34	$139.34	$305.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $139.21 / $265.12	Professional		$139.21	$139.21	$265.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.79 / $139.21 / $177.36	Professional		$138.79	$139.21	$177.36
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $98.31 / $139.21 / $266.64	Professional		$98.31	$139.21	$266.64
Medica Facility/Professional Facility Modifier Low / Median / High Price $95.48 / $139.34 / $234.35	Facility		$95.48	$139.34	$234.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $138.66 / $152.54 / $2,513.09	Professional		$138.66	$152.54	$2,513.09
Midlands Facility/Professional Facility Modifier Low / Median / High Price $95.94 / $204.64 / $249.74	Facility		$95.94	$204.64	$249.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $84.71 / $163.44 / $208.01	Professional		$84.71	$163.44	$208.01
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $275.64 / $290.80	Professional		$139.21	$275.64	$290.80
United Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $143.38 / $165.66	Professional		$139.21	$143.38	$165.66
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $151.75 / $151.75 / $151.75	Facility		$151.75	$151.75	$151.75
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $119.88 / $151.75 / $151.75	Professional		$119.88	$151.75	$151.75