Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $157.58 / $157.58 / $157.58	Facility		$157.58	$157.58	$157.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.40 / $79.40 / $109.94	Professional		$69.40	$79.40	$109.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $233.25 / $240.25 / $247.25	Facility		$233.25	$240.25	$247.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.28 / $190.82 / $238.53	Professional		$82.28	$190.82	$238.53
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $71.41 / $130.16 / $242.91	Professional		$71.41	$130.16	$242.91
Medica Facility/Professional Facility Modifier Low / Median / High Price $113.84 / $173.65 / $376.91	Facility		$113.84	$173.65	$376.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $80.78 / $146.82 / $612.74	Professional		$80.78	$146.82	$612.74
Midlands Facility/Professional Facility Modifier Low / Median / High Price $154.77 / $173.65 / $276.26	Facility		$154.77	$173.65	$276.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $143.40 / $173.65 / $276.26	Professional		$143.40	$173.65	$276.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $25.88 / $72.98 / $134.38	Professional		$25.88	$72.98	$134.38
United Facility/Professional Professional Modifier Low / Median / High Price $76.06 / $99.06 / $158.97	Professional		$76.06	$99.06	$158.97
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $110.05 / $139.30 / $163.90	Professional		$110.05	$139.30	$163.90