Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $133.72 / $133.72 / $141.51	Facility		$133.72	$133.72	$141.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.36 / $103.37 / $174.49	Professional		$55.36	$103.37	$174.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.42 / $107.42 / $210.63	Facility		$107.42	$107.42	$210.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.42 / $223.13 / $278.91	Professional		$107.42	$223.13	$278.91
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $181.91 / $210.31 / $227.90	Professional		$181.91	$210.31	$227.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $120.29 / $229.20 / $899.40	Facility		$120.29	$229.20	$899.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $102.02 / $261.60	Professional		$85.00	$102.02	$261.60
Midlands Facility/Professional Facility Modifier Low / Median / High Price $210.01 / $210.63 / $261.14	Facility		$210.01	$210.63	$261.14
Midlands Facility/Professional Professional Modifier Low / Median / High Price $188.00 / $246.04 / $402.49	Professional		$188.00	$246.04	$402.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $192.46 / $206.12 / $348.63	Professional		$192.46	$206.12	$348.63
United Facility/Professional Facility Modifier Low / Median / High Price $70.83 / $85.00 / $102.02	Facility		$70.83	$85.00	$102.02
United Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $95.52 / $182.25	Professional		$85.00	$95.52	$182.25
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $181.91 / $181.91 / $181.91	Facility		$181.91	$181.91	$181.91
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $143.71 / $181.91 / $181.91	Professional		$143.71	$181.91	$181.91