Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $337.73 / $602.72 / $919.02	Facility		$337.73	$602.72	$919.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $222.90 / $293.83 / $327.60	Professional		$222.90	$293.83	$327.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $405.28 / $613.63 / $767.04	Professional		$405.28	$613.63	$767.04
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $320.60 / $455.94 / $591.03	Professional		$320.60	$455.94	$591.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $187.73 / $405.28 / $776.78	Facility		$187.73	$405.28	$776.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $77.72 / $228.70 / $881.48	Professional		$77.72	$228.70	$881.48
Midlands Facility/Professional Facility Modifier Low / Median / High Price $211.01 / $440.89 / $740.16	Facility		$211.01	$440.89	$740.16
Midlands Facility/Professional Professional Modifier Low / Median / High Price $211.69 / $439.05 / $695.72	Professional		$211.69	$439.05	$695.72
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $337.73 / $337.73 / $602.85	Professional		$337.73	$337.73	$602.85
United Facility/Professional Professional Modifier Low / Median / High Price $82.45 / $202.64 / $395.14	Professional		$82.45	$202.64	$395.14
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $337.73 / $337.73 / $337.73	Professional		$337.73	$337.73	$337.73