Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $97.94 / $367.61	Professional		$97.94	$97.94	$367.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.80 / $106.80 / $221.98	Facility		$106.80	$106.80	$221.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.54 / $102.08 / $267.25	Professional		$85.54	$102.08	$267.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $150.00 / $200.00	Professional		$97.94	$150.00	$200.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $101.11 / $167.28 / $267.25	Facility		$101.11	$167.28	$267.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $107.92 / $107.92 / $298.47	Professional		$107.92	$107.92	$298.47
Midlands Facility/Professional Facility Modifier Low / Median / High Price $96.16 / $120.21 / $154.27	Facility		$96.16	$120.21	$154.27
Midlands Facility/Professional Professional Modifier Low / Median / High Price $94.03 / $120.21 / $267.25	Professional		$94.03	$120.21	$267.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $154.30 / $154.30 / $187.70	Professional		$154.30	$154.30	$187.70
United Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $97.94 / $107.73	Professional		$97.94	$97.94	$107.73
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $107.92 / $107.92 / $107.92	Facility		$107.92	$107.92	$107.92
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $85.26 / $107.92 / $107.92	Professional		$85.26	$107.92	$107.92