Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $156.75 / $304.95 / $426.55	Facility		$156.75	$304.95	$426.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.46 / $136.37 / $152.05	Professional		$103.46	$136.37	$152.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $188.25 / $285.27 / $356.59	Professional		$188.25	$285.27	$356.59
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $211.61 / $801.18	Professional		$150.00	$211.61	$801.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $156.75 / $202.27 / $401.28	Facility		$156.75	$202.27	$401.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $94.05 / $97.19 / $505.85	Professional		$94.05	$97.19	$505.85
Midlands Facility/Professional Facility Modifier Low / Median / High Price $188.10 / $238.26 / $322.91	Facility		$188.10	$238.26	$322.91
Midlands Facility/Professional Professional Modifier Low / Median / High Price $188.10 / $238.26 / $322.91	Professional		$188.10	$238.26	$322.91
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $156.75 / $156.75 / $279.80	Professional		$156.75	$156.75	$279.80
United Facility/Professional Facility Modifier Low / Median / High Price $156.75 / $156.75 / $360.53	Facility		$156.75	$156.75	$360.53
United Facility/Professional Professional Modifier Low / Median / High Price $94.05 / $94.05 / $341.72	Professional		$94.05	$94.05	$341.72
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $156.75 / $156.75 / $156.75	Professional		$156.75	$156.75	$156.75