Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $140.49 / $140.49 / $146.05	Facility		$140.49	$140.49	$146.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.20 / $108.30 / $181.61	Professional		$81.20	$108.30	$181.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.67 / $112.67 / $213.42	Facility		$112.67	$112.67	$213.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.67 / $234.38 / $292.97	Professional		$112.67	$234.38	$292.97
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $176.25 / $203.34 / $224.20	Professional		$176.25	$203.34	$224.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $121.88 / $238.83 / $939.42	Facility		$121.88	$238.83	$939.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $89.51 / $102.97 / $265.10	Professional		$89.51	$102.97	$265.10
Midlands Facility/Professional Facility Modifier Low / Median / High Price $212.80 / $213.42 / $273.92	Facility		$212.80	$213.42	$273.92
Midlands Facility/Professional Professional Modifier Low / Median / High Price $174.82 / $250.49 / $407.85	Professional		$174.82	$250.49	$407.85
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $197.90 / $211.95 / $360.91	Professional		$197.90	$211.95	$360.91
United Facility/Professional Professional Modifier Low / Median / High Price $89.15 / $96.80 / $228.34	Professional		$89.15	$96.80	$228.34
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $184.32 / $184.32 / $184.32	Facility		$184.32	$184.32	$184.32
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $145.61 / $184.32 / $184.32	Professional		$145.61	$184.32	$184.32