Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $101.13 / $101.13 / $101.13	Facility		$101.13	$101.13	$101.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.90 / $83.94 / $101.13	Professional		$80.90	$83.94	$101.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $166.16 / $166.16 / $178.51	Facility		$166.16	$166.16	$178.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.76 / $109.30 / $148.58	Professional		$90.76	$109.30	$148.58
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $120.82 / $206.55 / $264.37	Professional		$120.82	$206.55	$264.37
Medica Facility/Professional Facility Modifier Low / Median / High Price $80.90 / $105.78 / $167.39	Facility		$80.90	$105.78	$167.39
Medica Facility/Professional Professional Modifier Low / Median / High Price $120.09 / $136.47 / $272.94	Professional		$120.09	$136.47	$272.94
Midlands Facility/Professional Facility Modifier Low / Median / High Price $90.76 / $116.59 / $136.19	Facility		$90.76	$116.59	$136.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $105.78 / $116.64 / $167.39	Professional		$105.78	$116.64	$167.39
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $159.69 / $192.40 / $194.40	Professional		$159.69	$192.40	$194.40
United Facility/Professional Professional Modifier Low / Median / High Price $136.47 / $136.47 / $150.12	Professional		$136.47	$136.47	$150.12
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $91.01 / $91.01 / $91.01	Facility		$91.01	$91.01	$91.01
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $71.90 / $91.01 / $91.01	Professional		$71.90	$91.01	$91.01