Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $160.94 / $263.95 / $494.95	Facility		$160.94	$263.95	$494.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.75 / $150.38 / $218.76	Professional		$137.75	$150.38	$218.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $476.43 / $490.72 / $505.02	Facility		$476.43	$490.72	$505.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.66 / $384.75 / $480.93	Professional		$139.66	$384.75	$480.93
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $144.09 / $212.93 / $426.29	Professional		$144.09	$212.93	$426.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $160.94 / $325.50 / $1,231.92	Facility		$160.94	$325.50	$1,231.92
Medica Facility/Professional Professional Modifier Low / Median / High Price $153.35 / $232.41 / $1,102.83	Professional		$153.35	$232.41	$1,102.83
Midlands Facility/Professional Facility Modifier Low / Median / High Price $225.00 / $349.40 / $555.87	Facility		$225.00	$349.40	$555.87
Midlands Facility/Professional Professional Modifier Low / Median / High Price $205.00 / $325.50 / $428.76	Professional		$205.00	$325.50	$428.76
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $56.19 / $147.47 / $270.39	Professional		$56.19	$147.47	$270.39
United Facility/Professional Professional Modifier Low / Median / High Price $150.24 / $183.86 / $308.54	Professional		$150.24	$183.86	$308.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $221.44 / $280.30 / $329.80	Professional		$221.44	$280.30	$329.80