Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $331.13 / $478.63	Facility		$134.90	$331.13	$478.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $138.04 / $173.78	Professional		$123.03	$138.04	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $416.87	Professional		$331.13	$331.13	$416.87
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $229.09 / $316.23	Professional		$147.91	$229.09	$316.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $208.93 / $446.68	Facility		$173.78	$208.93	$446.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $173.78 / $707.95	Professional		$104.71	$173.78	$707.95
Midlands Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Professional		$208.93	$208.93	$208.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $190.55 / $371.54	Professional		$169.82	$190.55	$371.54
United Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $398.11	Facility		$173.78	$173.78	$398.11
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $446.68	Professional		$104.71	$104.71	$446.68
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Professional		$173.78	$173.78	$173.78