Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $380.19 / $549.54	Facility		$154.88	$380.19	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $173.78 / $426.58	Professional		$141.25	$173.78	$426.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $380.19 / $478.63	Professional		$257.04	$380.19	$478.63
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $331.13 / $363.08	Professional		$169.82	$331.13	$363.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $239.88 / $512.86	Facility		$199.53	$239.88	$512.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $239.88 / $776.25	Professional		$120.23	$239.88	$776.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $257.04	Professional		$239.88	$239.88	$257.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $218.78 / $426.58	Professional		$199.53	$218.78	$426.58
United Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $457.09	Facility		$199.53	$199.53	$457.09
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $501.19	Professional		$120.23	$120.23	$501.19
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Professional		$199.53	$199.53	$199.53