Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.37 / $245.37 / $245.37	Facility		$245.37	$245.37	$245.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.26 / $93.12 / $99.81	Professional		$92.26	$93.12	$99.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $644.39 / $663.72 / $683.05	Facility		$644.39	$663.72	$683.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $243.83 / $591.08 / $738.85	Professional		$243.83	$591.08	$738.85
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $237.36 / $336.34 / $509.55	Professional		$237.36	$336.34	$509.55
Medica Facility/Professional Facility Modifier Low / Median / High Price $133.78 / $257.00 / $575.59	Facility		$133.78	$257.00	$575.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $207.37 / $286.87 / $747.01	Professional		$207.37	$286.87	$747.01
Midlands Facility/Professional Facility Modifier Low / Median / High Price $133.78 / $230.94 / $606.64	Facility		$133.78	$230.94	$606.64
Midlands Facility/Professional Professional Modifier Low / Median / High Price $129.50 / $259.99 / $499.61	Professional		$129.50	$259.99	$499.61
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $60.93 / $112.92 / $369.05	Professional		$60.93	$112.92	$369.05
United Facility/Professional Professional Modifier Low / Median / High Price $207.37 / $287.16 / $509.39	Professional		$207.37	$287.16	$509.39
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $250.75 / $317.39 / $373.50	Professional		$250.75	$317.39	$373.50