Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $159.53 / $159.53 / $299.70	Facility		$159.53	$159.53	$299.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $136.66 / $290.08	Professional		$136.66	$136.66	$290.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.22 / $148.27 / $194.94	Professional		$135.22	$148.27	$194.94
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $97.31 / $161.72 / $360.15	Professional		$97.31	$161.72	$360.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $136.22 / $159.53 / $232.32	Facility		$136.22	$159.53	$232.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $136.22 / $151.65 / $586.87	Professional		$136.22	$151.65	$586.87
Midlands Facility/Professional Facility Modifier Low / Median / High Price $159.27 / $204.35 / $265.83	Facility		$159.27	$204.35	$265.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $159.27 / $172.79 / $292.63	Professional		$159.27	$172.79	$292.63
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $136.77 / $270.83 / $285.49	Professional		$136.77	$270.83	$285.49
United Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $140.77 / $162.63	Professional		$136.66	$140.77	$162.63
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $149.08 / $149.08 / $149.08	Facility		$149.08	$149.08	$149.08
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $117.77 / $149.08 / $149.08	Professional		$117.77	$149.08	$149.08