Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $219.38 / $395.90 / $690.44	Facility		$219.38	$395.90	$690.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.31 / $177.05 / $197.40	Professional		$134.31	$177.05	$197.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $244.20 / $369.48 / $461.86	Professional		$244.20	$369.48	$461.86
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $203.50 / $299.75 / $364.50	Professional		$203.50	$299.75	$364.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $203.50 / $264.55 / $505.63	Facility		$203.50	$264.55	$505.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $122.10 / $203.50 / $860.26	Professional		$122.10	$203.50	$860.26
Midlands Facility/Professional Facility Modifier Low / Median / High Price $244.20 / $361.07 / $455.65	Facility		$244.20	$361.07	$455.65
Midlands Facility/Professional Professional Modifier Low / Median / High Price $244.20 / $373.13 / $476.57	Professional		$244.20	$373.13	$476.57
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $203.50 / $203.50 / $363.25	Professional		$203.50	$203.50	$363.25
United Facility/Professional Professional Modifier Low / Median / High Price $122.10 / $122.10 / $443.63	Professional		$122.10	$122.10	$443.63
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $203.50 / $203.50 / $203.50	Professional		$203.50	$203.50	$203.50