Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $537.03 / $776.25	Facility		$218.78	$537.03	$776.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $223.87 / $281.84	Professional		$199.53	$223.87	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $537.03 / $676.08	Professional		$537.03	$537.03	$676.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $371.54 / $512.86	Professional		$151.36	$371.54	$512.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $338.84 / $645.65	Facility		$281.84	$338.84	$645.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $281.84 / $1,148.15	Professional		$169.82	$281.84	$1,148.15
Midlands Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Professional		$338.84	$338.84	$338.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $309.03 / $602.56	Professional		$281.84	$309.03	$602.56
United Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $645.65	Facility		$281.84	$281.84	$645.65
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $707.95	Professional		$169.82	$169.82	$707.95
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $281.84 / $281.84	Professional		$281.84	$281.84	$281.84