Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $174.81 / $340.07 / $475.68	Facility		$174.81	$340.07	$475.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.37 / $134.60 / $169.57	Professional		$115.37	$134.60	$169.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $209.77 / $317.26 / $396.58	Professional		$209.77	$317.26	$396.58
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $235.99 / $893.48	Professional		$150.00	$235.99	$893.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $174.81 / $225.58 / $447.51	Facility		$174.81	$225.58	$447.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $104.89 / $174.81 / $687.71	Professional		$104.89	$174.81	$687.71
Midlands Facility/Professional Facility Modifier Low / Median / High Price $209.77 / $332.79 / $493.44	Facility		$209.77	$332.79	$493.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $209.77 / $339.31 / $445.77	Professional		$209.77	$339.31	$445.77
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $170.09 / $174.81 / $312.04	Professional		$170.09	$174.81	$312.04
United Facility/Professional Professional Modifier Low / Median / High Price $104.89 / $104.89 / $442.09	Professional		$104.89	$104.89	$442.09
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $174.81 / $174.81 / $174.81	Professional		$174.81	$174.81	$174.81