Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Facility		$125.89	$125.89	$125.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $107.15 / $165.96	Professional		$74.13	$107.15	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $177.83 / $218.78	Professional		$120.23	$177.83	$218.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $169.82 / $269.15	Professional		$128.82	$169.82	$269.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $165.96 / $309.03	Facility		$95.50	$165.96	$309.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $89.13 / $309.03	Professional		$69.18	$89.13	$309.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $173.78 / $199.53	Professional		$165.96	$173.78	$199.53
Midlands Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $257.04 / $331.13	Professional		$120.23	$257.04	$331.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $218.78 / $331.13	Professional		$154.88	$218.78	$331.13
United Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $85.11	Facility		$75.86	$75.86	$85.11
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $75.86 / $125.89	Professional		$66.07	$75.86	$125.89
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Professional		$138.04	$138.04	$138.04