Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $79.43 / $234.42	Facility		$32.36	$79.43	$234.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $151.36 / $323.59	Professional		$107.15	$151.36	$323.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $426.58 / $436.52	Facility		$407.38	$426.58	$436.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $213.80 / $426.58	Professional		$147.91	$213.80	$426.58
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $199.53 / $524.81	Professional		$151.36	$199.53	$524.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $309.03 / $724.44	Facility		$138.04	$309.03	$724.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $251.19 / $1,023.29	Professional		$147.91	$251.19	$1,023.29
Midlands Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $380.19 / $575.44	Professional		$239.88	$380.19	$575.44
Midlands Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $436.52 / $436.52	Facility		$436.52	$436.52	$436.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $371.54 / $575.44	Professional		$331.13	$371.54	$575.44
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $288.40 / $812.83	Facility		$190.55	$288.40	$812.83
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $51.29 / $83.18	Professional		$20.89	$51.29	$83.18
United Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $162.18 / $234.42	Facility		$158.49	$162.18	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $194.98 / $354.81	Professional		$144.54	$194.98	$354.81
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $371.54 / $436.52	Professional		$371.54	$371.54	$436.52