Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.64 / $360.28 / $503.95	Facility		$199.64	$360.28	$503.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $122.23 / $161.12 / $179.64	Professional		$122.23	$161.12	$179.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $222.42 / $336.84 / $421.06	Professional		$222.42	$336.84	$421.06
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $203.72 / $324.10 / $557.00	Professional		$203.72	$324.10	$557.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $184.81 / $222.42 / $494.48	Facility		$184.81	$222.42	$494.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $111.12 / $185.20 / $728.59	Professional		$111.12	$185.20	$728.59
Midlands Facility/Professional Facility Modifier Low / Median / High Price $222.24 / $339.58 / $537.99	Facility		$222.24	$339.58	$537.99
Midlands Facility/Professional Professional Modifier Low / Median / High Price $222.24 / $339.58 / $472.26	Professional		$222.24	$339.58	$472.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $185.20 / $185.20 / $330.58	Professional		$185.20	$185.20	$330.58
United Facility/Professional Facility Modifier Low / Median / High Price $185.20 / $185.20 / $185.20	Facility		$185.20	$185.20	$185.20
United Facility/Professional Professional Modifier Low / Median / High Price $111.12 / $111.12 / $403.74	Professional		$111.12	$111.12	$403.74
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $185.20 / $185.20 / $185.20	Professional		$185.20	$185.20	$185.20