Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $185.20 / $360.28 / $503.95	Facility		$185.20	$360.28	$503.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $122.23 / $142.60 / $179.64	Professional		$122.23	$142.60	$179.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $222.24 / $336.84 / $421.06	Professional		$222.24	$336.84	$421.06
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $157.41 / $250.02 / $946.58	Professional		$157.41	$250.02	$946.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $185.20 / $238.99 / $474.11	Facility		$185.20	$238.99	$474.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $111.12 / $124.27 / $695.84	Professional		$111.12	$124.27	$695.84
Midlands Facility/Professional Facility Modifier Low / Median / High Price $222.24 / $281.19 / $405.89	Facility		$222.24	$281.19	$405.89
Midlands Facility/Professional Professional Modifier Low / Median / High Price $222.24 / $338.68 / $483.37	Professional		$222.24	$338.68	$483.37
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $185.20 / $185.20 / $330.58	Professional		$185.20	$185.20	$330.58
United Facility/Professional Professional Modifier Low / Median / High Price $111.12 / $111.12 / $468.37	Professional		$111.12	$111.12	$468.37
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $185.20 / $185.20 / $185.20	Professional		$185.20	$185.20	$185.20