Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $309.03 / $457.09	Facility		$125.89	$309.03	$457.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $141.25 / $162.18	Professional		$114.82	$141.25	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $316.23 / $389.05	Professional		$316.23	$316.23	$389.05
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $213.80 / $295.12	Professional		$138.04	$213.80	$295.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $213.80 / $389.05	Facility		$162.18	$213.80	$389.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $194.98 / $794.33	Professional		$97.72	$194.98	$794.33
Midlands Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Professional		$194.98	$194.98	$194.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $177.83 / $346.74	Professional		$158.49	$177.83	$346.74
United Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $380.19	Facility		$162.18	$162.18	$380.19
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $102.33 / $416.87	Professional		$97.72	$102.33	$416.87
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Professional		$162.18	$162.18	$162.18