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 / $112.90 / $183.39	Professional		$81.20	$112.90	$183.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.02 / $127.07 / $213.42	Facility		$106.02	$127.07	$213.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.42 / $236.72 / $292.97	Professional		$213.42	$236.72	$292.97
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $192.08 / $202.19 / $225.60	Professional		$192.08	$202.19	$225.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $132.06 / $233.27 / $939.42	Facility		$132.06	$233.27	$939.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $89.95 / $104.94 / $265.10	Professional		$89.95	$104.94	$265.10
Midlands Facility/Professional Facility Modifier Low / Median / High Price $213.42 / $213.42 / $273.92	Facility		$213.42	$213.42	$273.92
Midlands Facility/Professional Professional Modifier Low / Median / High Price $212.80 / $255.78 / $407.85	Professional		$212.80	$255.78	$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 $89.95 / $96.80 / $202.19	Professional		$89.95	$96.80	$202.19
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