Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.32 / $375.94 / $525.86	Facility		$208.32	$375.94	$525.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.55 / $148.80 / $187.45	Professional		$127.55	$148.80	$187.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $232.09 / $350.55 / $438.19	Professional		$232.09	$350.55	$438.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $212.58 / $349.78 / $566.39	Professional		$212.58	$349.78	$566.39
Medica Facility/Professional Facility Modifier Low / Median / High Price $193.25 / $249.38 / $494.72	Facility		$193.25	$249.38	$494.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $115.95 / $173.93 / $726.10	Professional		$115.95	$173.93	$726.10
Midlands Facility/Professional Facility Modifier Low / Median / High Price $231.90 / $270.55 / $423.53	Facility		$231.90	$270.55	$423.53
Midlands Facility/Professional Professional Modifier Low / Median / High Price $231.90 / $353.41 / $504.38	Professional		$231.90	$353.41	$504.38
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $193.25 / $193.25 / $344.95	Professional		$193.25	$193.25	$344.95
United Facility/Professional Facility Modifier Low / Median / High Price $193.25 / $193.25 / $193.25	Facility		$193.25	$193.25	$193.25
United Facility/Professional Professional Modifier Low / Median / High Price $115.95 / $115.95 / $395.68	Professional		$115.95	$115.95	$395.68
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $193.25 / $193.25 / $193.25	Professional		$193.25	$193.25	$193.25