Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $178.42 / $321.98 / $516.82	Facility		$178.42	$321.98	$516.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.24 / $143.99 / $160.54	Professional		$109.24	$143.99	$160.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $198.61 / $300.94 / $376.18	Professional		$198.61	$300.94	$376.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $165.51 / $248.27 / $299.57	Professional		$165.51	$248.27	$299.57
Medica Facility/Professional Facility Modifier Low / Median / High Price $165.51 / $213.57 / $380.67	Facility		$165.51	$213.57	$380.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $99.31 / $165.51 / $643.94	Professional		$99.31	$165.51	$643.94
Midlands Facility/Professional Facility Modifier Low / Median / High Price $198.61 / $270.27 / $362.73	Facility		$198.61	$270.27	$362.73
Midlands Facility/Professional Professional Modifier Low / Median / High Price $198.61 / $297.92 / $362.73	Professional		$198.61	$297.92	$362.73
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $165.51 / $165.51 / $295.44	Professional		$165.51	$165.51	$295.44
United Facility/Professional Facility Modifier Low / Median / High Price $165.51 / $165.51 / $380.67	Facility		$165.51	$165.51	$380.67
United Facility/Professional Professional Modifier Low / Median / High Price $99.31 / $99.31 / $339.72	Professional		$99.31	$99.31	$339.72
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $165.51 / $165.51 / $165.51	Professional		$165.51	$165.51	$165.51