Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $274.83 / $534.66 / $747.87	Facility		$274.83	$534.66	$747.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.39 / $211.62 / $266.58	Professional		$181.39	$211.62	$266.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $329.80 / $499.39 / $624.24	Professional		$329.80	$499.39	$624.24
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $233.61 / $371.02 / $1,404.67	Professional		$233.61	$371.02	$1,404.67
Medica Facility/Professional Facility Modifier Low / Median / High Price $274.83 / $354.65 / $703.56	Facility		$274.83	$354.65	$703.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $164.90 / $184.41 / $1,032.60	Professional		$164.90	$184.41	$1,032.60
Midlands Facility/Professional Facility Modifier Low / Median / High Price $329.80 / $417.29 / $602.32	Facility		$329.80	$417.29	$602.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $329.80 / $502.59 / $717.31	Professional		$329.80	$502.59	$717.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $274.83 / $274.83 / $490.57	Professional		$274.83	$274.83	$490.57
United Facility/Professional Professional Modifier Low / Median / High Price $164.90 / $164.90 / $599.13	Professional		$164.90	$164.90	$599.13
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $274.83 / $274.83 / $274.83	Professional		$274.83	$274.83	$274.83