Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.32 / $375.94 / $525.86	Facility		$208.32	$375.94	$525.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.55 / $168.13 / $187.45	Professional		$127.55	$168.13	$187.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $232.09 / $350.55 / $438.19	Professional		$232.09	$350.55	$438.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $212.58 / $338.19 / $515.32	Professional		$212.58	$338.19	$515.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $192.87 / $249.38 / $444.48	Facility		$192.87	$249.38	$444.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $115.95 / $193.25 / $758.57	Professional		$115.95	$193.25	$758.57
Midlands Facility/Professional Facility Modifier Low / Median / High Price $231.90 / $354.34 / $429.46	Facility		$231.90	$354.34	$429.46
Midlands Facility/Professional Professional Modifier Low / Median / High Price $231.90 / $354.34 / $492.79	Professional		$231.90	$354.34	$492.79
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $193.25 / $193.25 / $344.95	Professional		$193.25	$193.25	$344.95
United Facility/Professional Professional Modifier Low / Median / High Price $115.95 / $115.95 / $395.68	Professional		$115.95	$115.95	$395.68
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $193.25 / $193.25 / $193.25	Professional		$193.25	$193.25	$193.25