Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $166.08 / $166.08 / $1,150.20	Facility		$166.08	$166.08	$1,150.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $110.38 / $1,095.58	Professional		$108.47	$110.38	$1,095.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $153.26 / $191.58	Professional		$108.47	$153.26	$191.58
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $157.28 / $1,189.20	Professional		$108.47	$157.28	$1,189.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $109.28 / $166.08 / $610.48	Facility		$109.28	$166.08	$610.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $109.28 / $121.65 / $1,698.40	Professional		$109.28	$121.65	$1,698.40
Midlands Facility/Professional Facility Modifier Low / Median / High Price $141.04 / $180.49 / $327.88	Facility		$141.04	$180.49	$327.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $136.68 / $180.49 / $749.68	Professional		$136.68	$180.49	$749.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $215.31 / $230.96	Professional		$108.47	$215.31	$230.96
United Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $111.72 / $144.03	Professional		$108.47	$111.72	$144.03
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $119.59 / $119.59 / $119.59	Facility		$119.59	$119.59	$119.59
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $94.48 / $119.59 / $119.59	Professional		$94.48	$119.59	$119.59