Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.43 / $385.17 / $841.32	Facility		$213.43	$385.17	$841.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.66 / $172.25 / $192.05	Professional		$130.66	$172.25	$192.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $237.79 / $359.69 / $449.62	Professional		$237.79	$359.69	$449.62
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $197.99 / $326.68 / $692.15	Professional		$197.99	$326.68	$692.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $197.99 / $257.39 / $555.25	Facility		$197.99	$257.39	$555.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $118.79 / $203.93 / $989.95	Professional		$118.79	$203.93	$989.95
Midlands Facility/Professional Facility Modifier Low / Median / High Price $237.59 / $403.37 / $555.25	Facility		$237.59	$403.37	$555.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $237.79 / $403.37 / $567.23	Professional		$237.79	$403.37	$567.23
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $197.99 / $197.99 / $353.41	Professional		$197.99	$197.99	$353.41
United Facility/Professional Professional Modifier Low / Median / High Price $118.79 / $118.79 / $479.58	Professional		$118.79	$118.79	$479.58
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $197.99 / $197.99 / $197.99	Professional		$197.99	$197.99	$197.99