Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $132.74 / $132.74 / $541.91	Facility		$132.74	$132.74	$541.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.73 / $102.50 / $171.53	Professional		$76.73	$102.50	$171.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.63 / $106.63 / $209.12	Facility		$106.63	$106.63	$209.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.63 / $221.63 / $277.02	Professional		$106.63	$221.63	$277.02
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $180.60 / $203.20 / $215.80	Professional		$180.60	$203.20	$215.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $119.43 / $225.66 / $889.53	Facility		$119.43	$225.66	$889.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.13 / $98.40 / $259.23	Professional		$85.13	$98.40	$259.23
Midlands Facility/Professional Facility Modifier Low / Median / High Price $208.52 / $209.12 / $259.23	Facility		$208.52	$209.12	$259.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $171.26 / $244.28 / $399.63	Professional		$171.26	$244.28	$399.63
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $191.04 / $204.60 / $346.13	Professional		$191.04	$204.60	$346.13
United Facility/Professional Professional Modifier Low / Median / High Price $84.38 / $94.84 / $248.35	Professional		$84.38	$94.84	$248.35
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $180.60 / $180.60 / $180.60	Facility		$180.60	$180.60	$180.60
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $142.66 / $180.60 / $180.60	Professional		$142.66	$180.60	$180.60