Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $354.81 / $512.86	Facility		$141.25	$354.81	$512.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $147.91 / $186.21	Professional		$128.82	$147.91	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $354.81 / $446.68	Professional		$354.81	$354.81	$446.68
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $239.88 / $338.84	Professional		$151.36	$239.88	$338.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $223.87 / $426.58	Facility		$186.21	$223.87	$426.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $186.21 / $741.31	Professional		$112.20	$186.21	$741.31
Midlands Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Professional		$223.87	$223.87	$223.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $199.53 / $398.11	Professional		$186.21	$199.53	$398.11
United Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $186.21 / $426.58	Facility		$186.21	$186.21	$426.58
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $467.74	Professional		$112.20	$112.20	$467.74
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $186.21 / $186.21	Professional		$186.21	$186.21	$186.21