Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $146.32 / $146.32 / $146.32	Facility		$146.32	$146.32	$146.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $159.05 / $208.33 / $231.06	Professional		$159.05	$208.33	$231.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $461.85 / $475.71 / $489.56	Facility		$461.85	$475.71	$489.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.76 / $249.78 / $598.10	Professional		$87.76	$249.78	$598.10
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $103.56 / $162.80 / $371.74	Professional		$103.56	$162.80	$371.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $88.89 / $237.66 / $552.17	Facility		$88.89	$237.66	$552.17
Medica Facility/Professional Professional Modifier Low / Median / High Price $97.68 / $302.74 / $1,272.00	Professional		$97.68	$302.74	$1,272.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $81.20 / $189.00 / $569.52	Facility		$81.20	$189.00	$569.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $81.20 / $193.00 / $569.52	Professional		$81.20	$193.00	$569.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $132.19 / $165.30 / $390.80	Professional		$132.19	$165.30	$390.80
United Facility/Professional Professional Modifier Low / Median / High Price $115.04 / $302.74 / $504.56	Professional		$115.04	$302.74	$504.56
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $368.14 / $466.00 / $548.20	Professional		$368.14	$466.00	$548.20