Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $225.22 / $406.44 / $887.79	Facility		$225.22	$406.44	$887.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $160.87 / $181.76 / $294.26	Professional		$160.87	$181.76	$294.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $250.91 / $379.28 / $474.10	Professional		$250.91	$379.28	$474.10
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $208.92 / $344.72 / $558.26	Professional		$208.92	$344.72	$558.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $208.92 / $271.60 / $585.90	Facility		$208.92	$271.60	$585.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $125.35 / $215.19 / $1,044.59	Professional		$125.35	$215.19	$1,044.59
Midlands Facility/Professional Facility Modifier Low / Median / High Price $250.70 / $425.63 / $585.90	Facility		$250.70	$425.63	$585.90
Midlands Facility/Professional Professional Modifier Low / Median / High Price $250.91 / $425.63 / $598.54	Professional		$250.91	$425.63	$598.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $208.92 / $208.92 / $372.92	Professional		$208.92	$208.92	$372.92
United Facility/Professional Facility Modifier Low / Median / High Price $208.92 / $208.92 / $480.52	Facility		$208.92	$208.92	$480.52
United Facility/Professional Professional Modifier Low / Median / High Price $125.35 / $125.35 / $506.04	Professional		$125.35	$125.35	$506.04
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $208.92 / $208.92 / $208.92	Professional		$208.92	$208.92	$208.92