Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $116.58 / $116.58 / $116.58	Facility		$116.58	$116.58	$116.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.09 / $137.99 / $259.99	Professional		$113.09	$137.99	$259.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $399.84 / $411.84 / $423.83	Facility		$399.84	$411.84	$423.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $110.37 / $357.94 / $452.81	Professional		$110.37	$357.94	$452.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $115.75 / $180.65 / $456.30	Professional		$115.75	$180.65	$456.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $122.21 / $248.73 / $645.16	Facility		$122.21	$248.73	$645.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $108.82 / $227.75 / $1,029.11	Professional		$108.82	$227.75	$1,029.11
Midlands Facility/Professional Facility Modifier Low / Median / High Price $178.63 / $306.26 / $521.91	Facility		$178.63	$306.26	$521.91
Midlands Facility/Professional Professional Modifier Low / Median / High Price $146.22 / $321.24 / $398.73	Professional		$146.22	$321.24	$398.73
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $38.99 / $146.30 / $261.14	Professional		$38.99	$146.30	$261.14
United Facility/Professional Professional Modifier Low / Median / High Price $131.40 / $182.20 / $334.03	Professional		$131.40	$182.20	$334.03
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $215.91 / $273.30 / $321.50	Professional		$215.91	$273.30	$321.50