Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $229.94 / $414.95 / $588.71	Facility		$229.94	$414.95	$588.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.78 / $185.57 / $206.90	Professional		$140.78	$185.57	$206.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $255.96 / $387.11 / $483.89	Professional		$255.96	$387.11	$483.89
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $182.08 / $263.97 / $373.28	Professional		$182.08	$263.97	$373.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $202.64 / $256.17 / $490.59	Facility		$202.64	$256.17	$490.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $91.03 / $213.30 / $588.80	Professional		$91.03	$213.30	$588.80
Midlands Facility/Professional Facility Modifier Low / Median / High Price $247.11 / $298.62 / $467.46	Facility		$247.11	$298.62	$467.46
Midlands Facility/Professional Professional Modifier Low / Median / High Price $247.93 / $303.89 / $467.46	Professional		$247.93	$303.89	$467.46
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $213.30 / $213.30 / $380.74	Professional		$213.30	$213.30	$380.74
United Facility/Professional Professional Modifier Low / Median / High Price $96.56 / $127.98 / $464.99	Professional		$96.56	$127.98	$464.99
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $213.30 / $213.30 / $213.30	Professional		$213.30	$213.30	$213.30