Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.55 / $112.55 / $112.55	Facility		$112.55	$112.55	$112.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.46 / $59.46 / $80.93	Professional		$59.46	$59.46	$80.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $588.36 / $606.01 / $623.66	Facility		$588.36	$606.01	$623.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $318.81 / $318.81 / $398.52	Professional		$318.81	$318.81	$398.52
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $89.44 / $222.97 / $533.58	Professional		$89.44	$222.97	$533.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $49.81 / $291.79 / $1,382.36	Facility		$49.81	$291.79	$1,382.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $87.76 / $147.00 / $389.49	Professional		$87.76	$147.00	$389.49
Midlands Facility/Professional Facility Modifier Low / Median / High Price $44.11 / $437.27 / $623.66	Facility		$44.11	$437.27	$623.66
Midlands Facility/Professional Professional Modifier Low / Median / High Price $42.34 / $147.00 / $291.79	Professional		$42.34	$147.00	$291.79
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $20.16 / $38.93 / $600.71	Professional		$20.16	$38.93	$600.71
United Facility/Professional Professional Modifier Low / Median / High Price $123.63 / $135.99 / $252.21	Professional		$123.63	$135.99	$252.21
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $256.20 / $324.30 / $381.50	Professional		$256.20	$324.30	$381.50