Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $282.88 / $550.32 / $769.78	Facility		$282.88	$550.32	$769.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.70 / $217.82 / $274.39	Professional		$186.70	$217.82	$274.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $339.73 / $514.41 / $643.01	Professional		$339.73	$514.41	$643.01
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $240.45 / $381.89 / $512.01	Professional		$240.45	$381.89	$512.01
Medica Facility/Professional Facility Modifier Low / Median / High Price $282.88 / $365.04 / $724.17	Facility		$282.88	$365.04	$724.17
Medica Facility/Professional Professional Modifier Low / Median / High Price $169.73 / $175.39 / $912.88	Professional		$169.73	$175.39	$912.88
Midlands Facility/Professional Facility Modifier Low / Median / High Price $339.46 / $396.03 / $582.73	Facility		$339.46	$396.03	$582.73
Midlands Facility/Professional Professional Modifier Low / Median / High Price $339.46 / $429.98 / $582.73	Professional		$339.46	$429.98	$582.73
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $282.88 / $282.88 / $504.94	Professional		$282.88	$282.88	$504.94
United Facility/Professional Professional Modifier Low / Median / High Price $169.73 / $169.73 / $523.33	Professional		$169.73	$169.73	$523.33
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $282.88 / $282.88 / $282.88	Professional		$282.88	$282.88	$282.88