Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $181.92 / $328.29 / $459.21	Facility		$181.92	$328.29	$459.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.38 / $146.81 / $163.69	Professional		$111.38	$146.81	$163.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $202.66 / $306.82 / $383.52	Professional		$202.66	$306.82	$383.52
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $185.63 / $295.31 / $421.85	Professional		$185.63	$295.31	$421.85
Medica Facility/Professional Facility Modifier Low / Median / High Price $160.31 / $202.66 / $388.13	Facility		$160.31	$202.66	$388.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $101.25 / $168.75 / $662.41	Professional		$101.25	$168.75	$662.41
Midlands Facility/Professional Facility Modifier Low / Median / High Price $202.50 / $309.42 / $375.02	Facility		$202.50	$309.42	$375.02
Midlands Facility/Professional Professional Modifier Low / Median / High Price $202.50 / $309.42 / $430.31	Professional		$202.50	$309.42	$430.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $168.75 / $168.75 / $301.22	Professional		$168.75	$168.75	$301.22
United Facility/Professional Professional Modifier Low / Median / High Price $101.25 / $101.25 / $367.88	Professional		$101.25	$101.25	$367.88
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $168.75 / $168.75 / $168.75	Professional		$168.75	$168.75	$168.75