Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $188.44 / $340.07 / $475.68	Facility		$188.44	$340.07	$475.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.60 / $143.66 / $240.06	Professional		$134.60	$143.66	$240.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $209.94 / $317.26 / $396.58	Professional		$209.94	$317.26	$396.58
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $192.29 / $305.92 / $391.54	Professional		$192.29	$305.92	$391.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $174.56 / $225.58 / $402.06	Facility		$174.56	$225.58	$402.06
Medica Facility/Professional Professional Modifier Low / Median / High Price $104.89 / $174.81 / $686.20	Professional		$104.89	$174.81	$686.20
Midlands Facility/Professional Facility Modifier Low / Median / High Price $209.77 / $320.52 / $388.47	Facility		$209.77	$320.52	$388.47
Midlands Facility/Professional Professional Modifier Low / Median / High Price $209.77 / $320.52 / $445.77	Professional		$209.77	$320.52	$445.77
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $174.81 / $174.81 / $312.04	Professional		$174.81	$174.81	$312.04
United Facility/Professional Facility Modifier Low / Median / High Price $262.22 / $262.22 / $262.22	Facility		$262.22	$262.22	$262.22
United Facility/Professional Professional Modifier Low / Median / High Price $104.89 / $104.89 / $357.92	Professional		$104.89	$104.89	$357.92
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $174.81 / $174.81 / $174.81	Professional		$174.81	$174.81	$174.81