Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $104.71 / $169.82	Facility		$85.11	$104.71	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $85.11 / $144.54	Professional		$83.18	$85.11	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $107.15	Professional		$85.11	$85.11	$107.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $151.36 / $213.80	Professional		$69.18	$151.36	$213.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $93.33 / $141.25	Facility		$83.18	$93.33	$141.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $91.20 / $346.74	Professional		$83.18	$91.20	$346.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $102.33 / $123.03	Professional		$95.50	$102.33	$123.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $102.33 / $257.04	Professional		$95.50	$102.33	$257.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $147.91 / $177.83	Professional		$91.20	$147.91	$177.83
United Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Facility		$85.11	$85.11	$85.11
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $100.00	Professional		$85.11	$85.11	$100.00
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Facility		$89.13	$89.13	$89.13
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $89.13 / $89.13	Professional		$70.79	$89.13	$89.13