Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $147.00 / $208.22 / $379.95	Facility		$147.00	$208.22	$379.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.26 / $56.13 / $124.15	Professional		$49.26	$56.13	$124.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $287.72 / $296.35 / $304.98	Facility		$287.72	$296.35	$304.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.34 / $133.13 / $244.58	Professional		$76.34	$133.13	$244.58
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $54.52 / $223.01 / $361.76	Professional		$54.52	$223.01	$361.76
Medica Facility/Professional Facility Modifier Low / Median / High Price $81.59 / $217.76 / $720.23	Facility		$81.59	$217.76	$720.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $64.59 / $118.16 / $2,895.10	Professional		$64.59	$118.16	$2,895.10
Midlands Facility/Professional Facility Modifier Low / Median / High Price $108.50 / $133.13 / $322.00	Facility		$108.50	$133.13	$322.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $108.50 / $132.26 / $378.85	Professional		$108.50	$132.26	$378.85
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $52.60 / $74.00 / $106.60	Professional		$52.60	$74.00	$106.60
United Facility/Professional Professional Modifier Low / Median / High Price $58.97 / $76.48 / $165.08	Professional		$58.97	$76.48	$165.08
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $78.92 / $99.90 / $117.50	Professional		$78.92	$99.90	$117.50