Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $132.74 / $132.74 / $165.48	Facility		$132.74	$132.74	$165.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.73 / $106.86 / $171.53	Professional		$76.73	$106.86	$171.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $118.47 / $120.81 / $209.12	Facility		$118.47	$120.81	$209.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.81 / $221.63 / $277.02	Professional		$120.81	$221.63	$277.02
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $181.49 / $191.04 / $208.00	Professional		$181.49	$191.04	$208.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $124.98 / $224.42 / $889.53	Facility		$124.98	$224.42	$889.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.13 / $100.18 / $259.74	Professional		$85.13	$100.18	$259.74
Midlands Facility/Professional Facility Modifier Low / Median / High Price $209.12 / $209.12 / $259.23	Facility		$209.12	$209.12	$259.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $208.52 / $247.14 / $399.63	Professional		$208.52	$247.14	$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 $85.13 / $94.84 / $243.89	Professional		$85.13	$94.84	$243.89
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