Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $260.76 / $470.59 / $658.24	Facility		$260.76	$470.59	$658.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $159.65 / $210.45 / $234.64	Professional		$159.65	$210.45	$234.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $290.52 / $439.33 / $549.16	Professional		$290.52	$439.33	$549.16
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $266.08 / $423.33 / $640.36	Professional		$266.08	$423.33	$640.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $241.90 / $312.14 / $619.26	Facility		$241.90	$312.14	$619.26
Medica Facility/Professional Professional Modifier Low / Median / High Price $145.13 / $241.90 / $1,172.26	Professional		$145.13	$241.90	$1,172.26
Midlands Facility/Professional Facility Modifier Low / Median / High Price $290.27 / $492.81 / $663.67	Facility		$290.27	$492.81	$663.67
Midlands Facility/Professional Professional Modifier Low / Median / High Price $290.27 / $492.81 / $658.04	Professional		$290.27	$492.81	$658.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $241.90 / $241.90 / $431.79	Professional		$241.90	$241.90	$431.79
United Facility/Professional Professional Modifier Low / Median / High Price $145.13 / $145.13 / $585.91	Professional		$145.13	$145.13	$585.91
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $241.90 / $241.90 / $241.90	Professional		$241.90	$241.90	$241.90