Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $185.53 / $185.53 / $185.53	Facility		$185.53	$185.53	$185.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.98 / $64.72 / $99.24	Professional		$57.98	$64.72	$99.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $263.27 / $271.17 / $279.07	Facility		$263.27	$271.17	$279.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.94 / $162.90 / $217.85	Professional		$72.94	$162.90	$217.85
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $60.83 / $90.97 / $272.42	Professional		$60.83	$90.97	$272.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $94.96 / $183.00 / $454.08	Facility		$94.96	$183.00	$454.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.63 / $132.69 / $678.50	Professional		$75.63	$132.69	$678.50
Midlands Facility/Professional Facility Modifier Low / Median / High Price $129.94 / $158.68 / $279.07	Facility		$129.94	$158.68	$279.07
Midlands Facility/Professional Professional Modifier Low / Median / High Price $129.94 / $157.08 / $235.48	Professional		$129.94	$157.08	$235.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $92.60 / $92.60 / $241.40	Professional		$92.60	$92.60	$241.40
United Facility/Professional Facility Modifier Low / Median / High Price $310.68 / $314.60 / $460.26	Facility		$310.68	$314.60	$460.26
United Facility/Professional Professional Modifier Low / Median / High Price $70.81 / $89.65 / $148.50	Professional		$70.81	$89.65	$148.50
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $101.28 / $128.19 / $150.80	Professional		$101.28	$128.19	$150.80