Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.11 / $160.52 / $253.31	Professional		$95.11	$160.52	$253.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $210.98 / $290.20 / $481.09	Professional		$210.98	$290.20	$481.09
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $101.73 / $223.77 / $472.45	Professional		$101.73	$223.77	$472.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $162.06 / $271.27 / $661.20	Facility		$162.06	$271.27	$661.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $168.18 / $304.89 / $1,094.99	Professional		$168.18	$304.89	$1,094.99
Midlands Facility/Professional Facility Modifier Low / Median / High Price $175.59 / $269.00 / $416.44	Facility		$175.59	$269.00	$416.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $211.83 / $303.64 / $422.56	Professional		$211.83	$303.64	$422.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $104.74 / $194.44 / $316.75	Professional		$104.74	$194.44	$316.75
United Facility/Professional Facility Modifier Low / Median / High Price $1,204.00 / $1,640.00 / $2,126.00	Facility		$1,204.00	$1,640.00	$2,126.00
United Facility/Professional Professional Modifier Low / Median / High Price $154.62 / $236.08 / $480.32	Professional		$154.62	$236.08	$480.32
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $201.50 / $237.10 / $382.00	Professional		$201.50	$237.10	$382.00