Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $173.78 / $251.19	Facility		$70.79	$173.78	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $79.43 / $91.20	Professional		$64.57	$79.43	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $218.78	Professional		$173.78	$173.78	$218.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $123.03 / $165.96	Professional		$77.62	$123.03	$165.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $117.49 / $218.78	Facility		$91.20	$117.49	$218.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $109.65 / $446.68	Professional		$54.95	$109.65	$446.68
Midlands Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Professional		$109.65	$109.65	$109.65
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $100.00 / $194.98	Professional		$89.13	$100.00	$194.98
United Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $208.93	Facility		$91.20	$91.20	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $56.23 / $234.42	Professional		$54.95	$56.23	$234.42
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Professional		$91.20	$91.20	$91.20