Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $314.08 / $566.82 / $908.90	Facility		$314.08	$566.82	$908.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $224.35 / $253.48 / $379.44	Professional		$224.35	$253.48	$379.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $349.63 / $529.41 / $661.78	Professional		$349.63	$529.41	$661.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $291.36 / $460.87 / $668.15	Professional		$291.36	$460.87	$668.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $291.36 / $375.98 / $670.13	Facility		$291.36	$375.98	$670.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $174.82 / $291.36 / $1,132.49	Professional		$174.82	$291.36	$1,132.49
Midlands Facility/Professional Facility Modifier Low / Median / High Price $349.63 / $475.31 / $638.54	Facility		$349.63	$475.31	$638.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $349.63 / $524.45 / $638.54	Professional		$349.63	$524.45	$638.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $291.36 / $291.36 / $520.08	Professional		$291.36	$291.36	$520.08
United Facility/Professional Professional Modifier Low / Median / High Price $174.82 / $174.82 / $941.67	Professional		$174.82	$174.82	$941.67
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $291.36 / $291.36 / $291.36	Professional		$291.36	$291.36	$291.36