Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $299.91 / $616.49 / $1,657.60	Facility		$299.91	$616.49	$1,657.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.12 / $226.89 / $252.97	Professional		$172.12	$226.89	$252.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $313.20 / $473.28 / $591.60	Professional		$313.20	$473.28	$591.60
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $260.79 / $430.30 / $670.67	Professional		$260.79	$430.30	$670.67
Medica Facility/Professional Facility Modifier Low / Median / High Price $260.79 / $339.03 / $731.35	Facility		$260.79	$339.03	$731.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $156.47 / $268.61 / $1,303.95	Professional		$156.47	$268.61	$1,303.95
Midlands Facility/Professional Facility Modifier Low / Median / High Price $312.95 / $531.29 / $731.35	Facility		$312.95	$531.29	$731.35
Midlands Facility/Professional Professional Modifier Low / Median / High Price $313.20 / $531.29 / $747.14	Professional		$313.20	$531.29	$747.14
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $260.79 / $260.79 / $465.51	Professional		$260.79	$260.79	$465.51
United Facility/Professional Professional Modifier Low / Median / High Price $156.47 / $156.47 / $711.51	Professional		$156.47	$156.47	$711.51
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $260.79 / $260.79 / $260.79	Professional		$260.79	$260.79	$260.79