Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $206.98 / $373.52 / $522.47	Facility		$206.98	$373.52	$522.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.72 / $167.04 / $186.24	Professional		$126.72	$167.04	$186.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $230.59 / $349.25 / $436.56	Professional		$230.59	$349.25	$436.56
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $183.82 / $266.50 / $336.00	Professional		$183.82	$266.50	$336.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $147.84 / $230.59 / $491.52	Facility		$147.84	$230.59	$491.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $50.20 / $136.38 / $529.91	Professional		$50.20	$136.38	$529.91
Midlands Facility/Professional Facility Modifier Low / Median / High Price $230.40 / $252.29 / $557.74	Facility		$230.40	$252.29	$557.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $165.34 / $250.64 / $489.60	Professional		$165.34	$250.64	$489.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $192.00 / $192.00 / $342.72	Professional		$192.00	$192.00	$342.72
United Facility/Professional Professional Modifier Low / Median / High Price $53.26 / $115.20 / $241.81	Professional		$53.26	$115.20	$241.81
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $192.00 / $192.00 / $192.00	Professional		$192.00	$192.00	$192.00