Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $323.59 / $478.63	Facility		$104.71	$323.59	$478.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $83.18 / $371.54	Professional		$58.88	$83.18	$371.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $234.42 / $239.88	Facility		$223.87	$234.42	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $165.96 / $208.93	Professional		$162.18	$165.96	$208.93
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $117.49 / $371.54	Professional		$72.44	$117.49	$371.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $162.18 / $234.42	Facility		$134.90	$162.18	$234.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $128.82 / $331.13	Professional		$75.86	$128.82	$331.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $162.18 / $257.04	Professional		$141.25	$162.18	$257.04
Midlands Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $239.88 / $239.88	Facility		$239.88	$239.88	$239.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $190.55	Professional		$165.96	$165.96	$190.55
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $75.86 / $147.91	Professional		$69.18	$75.86	$147.91
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $91.20 / $158.49	Professional		$75.86	$91.20	$158.49
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $131.83 / $154.88	Professional		$102.33	$131.83	$154.88