Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.32 / $375.94 / $615.12	Facility		$208.32	$375.94	$615.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.55 / $168.13 / $187.45	Professional		$127.55	$168.13	$187.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $231.90 / $350.55 / $438.19	Professional		$231.90	$350.55	$438.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $193.25 / $318.86 / $560.79	Professional		$193.25	$318.86	$560.79
Medica Facility/Professional Facility Modifier Low / Median / High Price $193.25 / $249.38 / $450.48	Facility		$193.25	$249.38	$450.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $115.95 / $193.25 / $766.43	Professional		$115.95	$193.25	$766.43
Midlands Facility/Professional Facility Modifier Low / Median / High Price $231.90 / $321.68 / $423.53	Facility		$231.90	$321.68	$423.53
Midlands Facility/Professional Professional Modifier Low / Median / High Price $231.90 / $348.67 / $424.58	Professional		$231.90	$348.67	$424.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $193.25 / $193.25 / $344.95	Professional		$193.25	$193.25	$344.95
United Facility/Professional Facility Modifier Low / Median / High Price $193.25 / $193.25 / $444.48	Facility		$193.25	$193.25	$444.48
United Facility/Professional Professional Modifier Low / Median / High Price $115.95 / $115.95 / $404.34	Professional		$115.95	$115.95	$404.34
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $193.25 / $193.25 / $193.25	Professional		$193.25	$193.25	$193.25