Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $189.08 / $341.23 / $477.30	Facility		$189.08	$341.23	$477.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.76 / $152.60 / $170.14	Professional		$115.76	$152.60	$170.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $210.66 / $318.57 / $398.21	Professional		$210.66	$318.57	$398.21
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $192.94 / $306.95 / $339.76	Professional		$192.94	$306.95	$339.76
Medica Facility/Professional Facility Modifier Low / Median / High Price $175.11 / $210.66 / $468.32	Facility		$175.11	$210.66	$468.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $105.24 / $175.40 / $690.05	Professional		$105.24	$175.40	$690.05
Midlands Facility/Professional Facility Modifier Low / Median / High Price $210.48 / $321.62 / $509.53	Facility		$210.48	$321.62	$509.53
Midlands Facility/Professional Professional Modifier Low / Median / High Price $210.48 / $321.62 / $447.27	Professional		$210.48	$321.62	$447.27
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $175.40 / $175.40 / $313.08	Professional		$175.40	$175.40	$313.08
United Facility/Professional Facility Modifier Low / Median / High Price $175.40 / $175.40 / $175.40	Facility		$175.40	$175.40	$175.40
United Facility/Professional Professional Modifier Low / Median / High Price $105.24 / $105.24 / $478.54	Professional		$105.24	$105.24	$478.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $175.40 / $175.40 / $175.40	Professional		$175.40	$175.40	$175.40