Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.88 / $134.88 / $431.50	Professional		$134.88	$134.88	$431.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.05 / $163.77 / $191.34	Professional		$139.05	$163.77	$191.34
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $134.88 / $161.10 / $275.39	Professional		$134.88	$161.10	$275.39
Medica Facility/Professional Facility Modifier Low / Median / High Price $137.19 / $186.44 / $417.59	Facility		$137.19	$186.44	$417.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $137.19 / $137.19 / $274.38	Professional		$137.19	$137.19	$274.38
Midlands Facility/Professional Facility Modifier Low / Median / High Price $163.49 / $163.84 / $215.12	Facility		$163.49	$163.84	$215.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $163.49 / $165.12 / $215.12	Professional		$163.49	$165.12	$215.12
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $236.00 / $236.00 / $287.00	Professional		$236.00	$236.00	$287.00
United Facility/Professional Professional Modifier Low / Median / High Price $134.88 / $134.88 / $145.68	Professional		$134.88	$134.88	$145.68
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $137.19 / $137.19 / $137.19	Facility		$137.19	$137.19	$137.19
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $108.38 / $137.19 / $137.19	Professional		$108.38	$137.19	$137.19