Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $389.05 / $588.84	Facility		$154.88	$389.05	$588.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $173.78 / $407.38	Professional		$141.25	$173.78	$407.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $389.05 / $489.78	Professional		$263.03	$389.05	$489.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $354.81 / $489.78	Professional		$173.78	$354.81	$489.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $245.47 / $467.74	Facility		$204.17	$245.47	$467.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $245.47 / $794.33	Professional		$120.23	$245.47	$794.33
Midlands Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $263.03	Professional		$245.47	$245.47	$263.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $218.78 / $426.58	Professional		$204.17	$218.78	$426.58
United Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $467.74	Facility		$204.17	$204.17	$467.74
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $512.86	Professional		$120.23	$120.23	$512.86
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Professional		$204.17	$204.17	$204.17