Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $165.96	Facility		$125.89	$125.89	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $109.65 / $208.93	Professional		$83.18	$109.65	$208.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $223.87	Facility		$117.49	$117.49	$223.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $208.93 / $263.03	Professional		$117.49	$208.93	$263.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $181.97 / $199.53	Professional		$169.82	$181.97	$199.53
Medica Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $239.88 / $954.99	Facility		$138.04	$239.88	$954.99
Medica Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $123.03 / $338.84	Professional		$89.13	$123.03	$338.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $229.09 / $275.42	Professional		$218.78	$229.09	$275.42
Midlands Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Facility		$223.87	$223.87	$223.87
Midlands Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $338.84 / $338.84	Professional		$208.93	$338.84	$338.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $257.04 / $389.05	Professional		$181.97	$257.04	$389.05
United Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $120.23 / $295.12	Facility		$69.18	$120.23	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $100.00 / $181.97	Professional		$89.13	$100.00	$181.97
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $194.98 / $194.98	Professional		$154.88	$194.98	$194.98