Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $188.44 / $340.07 / $545.33	Facility		$188.44	$340.07	$545.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.37 / $152.08 / $169.57	Professional		$115.37	$152.08	$169.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $209.77 / $317.26 / $396.58	Professional		$209.77	$317.26	$396.58
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $174.81 / $270.07 / $391.54	Professional		$174.81	$270.07	$391.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $174.81 / $225.58 / $402.06	Facility		$174.81	$225.58	$402.06
Medica Facility/Professional Professional Modifier Low / Median / High Price $104.89 / $174.81 / $679.49	Professional		$104.89	$174.81	$679.49
Midlands Facility/Professional Facility Modifier Low / Median / High Price $209.77 / $285.17 / $383.10	Facility		$209.77	$285.17	$383.10
Midlands Facility/Professional Professional Modifier Low / Median / High Price $209.77 / $314.66 / $383.10	Professional		$209.77	$314.66	$383.10
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $174.81 / $174.81 / $312.04	Professional		$174.81	$174.81	$312.04
United Facility/Professional Professional Modifier Low / Median / High Price $104.89 / $104.89 / $358.48	Professional		$104.89	$104.89	$358.48
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $174.81 / $174.81 / $174.81	Professional		$174.81	$174.81	$174.81