Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $260.50 / $506.79 / $708.89	Facility		$260.50	$506.79	$708.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.93 / $200.59 / $252.69	Professional		$171.93	$200.59	$252.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $312.60 / $473.28 / $591.60	Professional		$312.60	$473.28	$591.60
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $221.43 / $351.68 / $471.51	Professional		$221.43	$351.68	$471.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $247.48 / $339.00 / $666.88	Facility		$247.48	$339.00	$666.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $156.30 / $165.81 / $1,017.59	Professional		$156.30	$165.81	$1,017.59
Midlands Facility/Professional Facility Modifier Low / Median / High Price $312.60 / $455.88 / $666.88	Facility		$312.60	$455.88	$666.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $312.60 / $455.88 / $672.24	Professional		$312.60	$455.88	$672.24
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $260.50 / $260.50 / $464.99	Professional		$260.50	$260.50	$464.99
United Facility/Professional Professional Modifier Low / Median / High Price $156.30 / $156.30 / $481.93	Professional		$156.30	$156.30	$481.93
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $260.50 / $260.50 / $260.50	Professional		$260.50	$260.50	$260.50