Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $185.34 / $330.50 / $503.95	Facility		$185.34	$330.50	$503.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $135.10 / $152.22 / $254.33	Professional		$135.10	$152.22	$254.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $222.42 / $336.84 / $421.06	Professional		$222.42	$336.84	$421.06
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $203.72 / $324.10 / $571.23	Professional		$203.72	$324.10	$571.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $185.20 / $238.99 / $474.11	Facility		$185.20	$238.99	$474.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $111.12 / $166.68 / $695.84	Professional		$111.12	$166.68	$695.84
Midlands Facility/Professional Facility Modifier Low / Median / High Price $222.24 / $259.27 / $405.89	Facility		$222.24	$259.27	$405.89
Midlands Facility/Professional Professional Modifier Low / Median / High Price $222.24 / $338.68 / $483.37	Professional		$222.24	$338.68	$483.37
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $216.91 / $216.91 / $216.91	Facility		$216.91	$216.91	$216.91
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $185.20 / $185.20 / $330.58	Professional		$185.20	$185.20	$330.58
United Facility/Professional Professional Modifier Low / Median / High Price $111.12 / $111.12 / $597.66	Professional		$111.12	$111.12	$597.66
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $185.20 / $185.20 / $185.20	Professional		$185.20	$185.20	$185.20