Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $288.40 / $331.13	Facility		$93.33	$288.40	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $104.71 / $125.89	Professional		$85.11	$104.71	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $295.12	Professional		$234.42	$234.42	$295.12
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $158.49 / $218.78	Professional		$104.71	$158.49	$218.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $147.91 / $309.03	Facility		$123.03	$147.91	$309.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $147.91 / $602.56	Professional		$72.44	$147.91	$602.56
Midlands Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $147.91	Professional		$147.91	$147.91	$147.91
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $131.83 / $257.04	Professional		$117.49	$131.83	$257.04
United Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $281.84	Facility		$123.03	$123.03	$281.84
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $75.86 / $331.13	Professional		$72.44	$75.86	$331.13
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Professional		$123.03	$123.03	$123.03