Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.19 / $393.76 / $593.91	Facility		$218.19	$393.76	$593.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.58 / $176.09 / $196.33	Professional		$133.58	$176.09	$196.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $242.88 / $367.53 / $459.41	Professional		$242.88	$367.53	$459.41
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $202.40 / $333.96 / $490.06	Professional		$202.40	$333.96	$490.06
Medica Facility/Professional Facility Modifier Low / Median / High Price $202.40 / $256.01 / $465.52	Facility		$202.40	$256.01	$465.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $114.41 / $202.40 / $740.04	Professional		$114.41	$202.40	$740.04
Midlands Facility/Professional Facility Modifier Low / Median / High Price $242.88 / $310.58 / $443.58	Facility		$242.88	$310.58	$443.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $242.88 / $364.32 / $443.58	Professional		$242.88	$364.32	$443.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $202.40 / $202.40 / $361.28	Professional		$202.40	$202.40	$361.28
United Facility/Professional Professional Modifier Low / Median / High Price $114.41 / $121.44 / $390.42	Professional		$114.41	$121.44	$390.42
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $202.40 / $202.40 / $202.40	Professional		$202.40	$202.40	$202.40