Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $217.22 / $392.01 / $870.10	Facility		$217.22	$392.01	$870.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $155.16 / $175.31 / $283.81	Professional		$155.16	$175.31	$283.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $242.01 / $366.22 / $457.78	Professional		$242.01	$366.22	$457.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $201.50 / $332.48 / $495.11	Professional		$201.50	$332.48	$495.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $201.50 / $261.95 / $565.10	Facility		$201.50	$261.95	$565.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $120.90 / $207.55 / $1,007.50	Professional		$120.90	$207.55	$1,007.50
Midlands Facility/Professional Facility Modifier Low / Median / High Price $241.80 / $410.51 / $565.10	Facility		$241.80	$410.51	$565.10
Midlands Facility/Professional Professional Modifier Low / Median / High Price $242.01 / $410.51 / $577.29	Professional		$242.01	$410.51	$577.29
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $201.50 / $201.50 / $359.68	Professional		$201.50	$201.50	$359.68
United Facility/Professional Professional Modifier Low / Median / High Price $120.90 / $120.90 / $549.75	Professional		$120.90	$120.90	$549.75
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $201.50 / $201.50 / $201.50	Professional		$201.50	$201.50	$201.50