Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $101.15 / $101.15 / $181.03	Facility		$101.15	$101.15	$181.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $81.90 / $174.68	Professional		$81.90	$81.90	$174.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.33 / $88.85 / $116.99	Professional		$80.33	$88.85	$116.99
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $63.68 / $101.23 / $215.74	Professional		$63.68	$101.23	$215.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $82.86 / $101.15 / $144.24	Facility		$82.86	$101.15	$144.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $82.86 / $92.24 / $350.34	Professional		$82.86	$92.24	$350.34
Midlands Facility/Professional Facility Modifier Low / Median / High Price $94.63 / $122.19 / $160.65	Facility		$94.63	$122.19	$160.65
Midlands Facility/Professional Professional Modifier Low / Median / High Price $94.63 / $103.15 / $173.23	Professional		$94.63	$103.15	$173.23
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $84.30 / $162.30 / $171.08	Professional		$84.30	$162.30	$171.08
United Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $84.36 / $97.46	Professional		$81.90	$84.36	$97.46
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $90.68 / $90.68 / $90.68	Facility		$90.68	$90.68	$90.68
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $71.64 / $90.68 / $90.68	Professional		$71.64	$90.68	$90.68