Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.94 / $151.94 / $151.94	Facility		$151.94	$151.94	$151.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.42 / $95.70 / $367.20	Professional		$75.42	$95.70	$367.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $262.20 / $270.07 / $277.93	Facility		$262.20	$270.07	$277.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $202.02 / $230.38 / $287.98	Professional		$202.02	$230.38	$287.98
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $88.49 / $149.47 / $411.09	Professional		$88.49	$149.47	$411.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $64.28 / $173.27 / $248.48	Facility		$64.28	$173.27	$248.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.22 / $161.85 / $798.89	Professional		$85.22	$161.85	$798.89
Midlands Facility/Professional Facility Modifier Low / Median / High Price $66.90 / $184.45 / $270.07	Facility		$66.90	$184.45	$270.07
Midlands Facility/Professional Professional Modifier Low / Median / High Price $64.28 / $184.45 / $237.98	Professional		$64.28	$184.45	$237.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $164.60 / $164.60 / $164.60	Professional		$164.60	$164.60	$164.60
United Facility/Professional Professional Modifier Low / Median / High Price $93.76 / $128.51 / $356.03	Professional		$93.76	$128.51	$356.03
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $151.80 / $151.80 / $178.60	Professional		$151.80	$151.80	$178.60