Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $189.08 / $341.23 / $558.32	Facility		$189.08	$341.23	$558.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.76 / $152.60 / $170.14	Professional		$115.76	$152.60	$170.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $210.48 / $318.57 / $398.21	Professional		$210.48	$318.57	$398.21
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $175.40 / $289.41 / $384.74	Professional		$175.40	$289.41	$384.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $175.40 / $226.34 / $408.88	Facility		$175.40	$226.34	$408.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $105.24 / $175.40 / $695.69	Professional		$105.24	$175.40	$695.69
Midlands Facility/Professional Facility Modifier Low / Median / High Price $210.48 / $291.97 / $384.40	Facility		$210.48	$291.97	$384.40
Midlands Facility/Professional Professional Modifier Low / Median / High Price $210.48 / $316.48 / $385.39	Professional		$210.48	$316.48	$385.39
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $175.40 / $175.40 / $313.08	Professional		$175.40	$175.40	$313.08
United Facility/Professional Professional Modifier Low / Median / High Price $105.24 / $105.24 / $382.37	Professional		$105.24	$105.24	$382.37
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $175.40 / $175.40 / $175.40	Professional		$175.40	$175.40	$175.40