Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $270.57 / $270.57 / $270.57	Facility		$270.57	$270.57	$270.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $101.72 / $270.57	Professional		$101.72	$101.72	$270.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.10 / $122.62 / $151.69	Professional		$104.10	$122.62	$151.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $81.38 / $101.72 / $184.11	Professional		$81.38	$101.72	$184.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $100.72 / $156.12 / $417.59	Facility		$100.72	$156.12	$417.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $100.72 / $100.72 / $226.00	Professional		$100.72	$100.72	$226.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $120.86 / $133.02 / $175.02	Facility		$120.86	$133.02	$175.02
Midlands Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $130.00 / $175.02	Professional		$120.00	$130.00	$175.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $186.90 / $186.90 / $227.30	Professional		$186.90	$186.90	$227.30
United Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $101.72 / $111.89	Professional		$101.72	$101.72	$111.89
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $100.72 / $100.72 / $100.72	Facility		$100.72	$100.72	$100.72
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $79.56 / $100.72 / $100.72	Professional		$79.56	$100.72	$100.72