Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $151.36	Facility		$75.86	$75.86	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $91.20 / $363.08	Professional		$75.86	$91.20	$363.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $269.15 / $275.42	Facility		$263.03	$269.15	$275.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $234.42 / $295.12	Professional		$218.78	$234.42	$295.12
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $162.18 / $616.60	Professional		$112.20	$162.18	$616.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $173.78 / $269.15	Facility		$64.57	$173.78	$269.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $141.25 / $398.11	Professional		$81.28	$141.25	$398.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $234.42 / $331.13	Professional		$204.17	$234.42	$331.13
Midlands Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Facility		$275.42	$275.42	$275.42
Midlands Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $218.78 / $239.88	Professional		$186.21	$218.78	$239.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $181.97	Professional		$181.97	$181.97	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $117.49 / $245.47	Professional		$89.13	$117.49	$245.47
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $177.83	Professional		$151.36	$151.36	$177.83