Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $238.61 / $238.61 / $238.61	Facility		$238.61	$238.61	$238.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.50 / $114.06 / $160.47	Professional		$94.50	$114.06	$160.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $398.33 / $410.28 / $422.23	Facility		$398.33	$410.28	$422.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.50 / $328.91 / $442.15	Professional		$119.50	$328.91	$442.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $143.44 / $223.25 / $505.76	Professional		$143.44	$223.25	$505.76
Medica Facility/Professional Facility Modifier Low / Median / High Price $76.84 / $238.61 / $401.95	Facility		$76.84	$238.61	$401.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $132.47 / $209.00 / $854.73	Professional		$132.47	$209.00	$854.73
Midlands Facility/Professional Facility Modifier Low / Median / High Price $72.23 / $263.00 / $410.28	Facility		$72.23	$263.00	$410.28
Midlands Facility/Professional Professional Modifier Low / Median / High Price $72.23 / $264.64 / $357.63	Professional		$72.23	$264.64	$357.63
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $103.90 / $186.00 / $232.40	Professional		$103.90	$186.00	$232.40
United Facility/Professional Professional Modifier Low / Median / High Price $139.77 / $184.93 / $315.58	Professional		$139.77	$184.93	$315.58
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $175.46 / $222.10 / $261.30	Professional		$175.46	$222.10	$261.30