Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.56 / $360.13 / $503.74	Facility		$199.56	$360.13	$503.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $122.18 / $161.05 / $179.57	Professional		$122.18	$161.05	$179.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $222.33 / $336.19 / $420.24	Professional		$222.33	$336.19	$420.24
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $203.63 / $323.95 / $634.04	Professional		$203.63	$323.95	$634.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $185.12 / $238.89 / $494.27	Facility		$185.12	$238.89	$494.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $111.07 / $185.12 / $597.40	Professional		$111.07	$185.12	$597.40
Midlands Facility/Professional Facility Modifier Low / Median / High Price $222.14 / $339.44 / $411.39	Facility		$222.14	$339.44	$411.39
Midlands Facility/Professional Professional Modifier Low / Median / High Price $222.14 / $310.64 / $431.88	Professional		$222.14	$310.64	$431.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $185.12 / $185.12 / $330.44	Professional		$185.12	$185.12	$330.44
United Facility/Professional Professional Modifier Low / Median / High Price $111.07 / $111.07 / $379.03	Professional		$111.07	$111.07	$379.03
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $185.12 / $185.12 / $185.12	Professional		$185.12	$185.12	$185.12