Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.19 / $393.76 / $550.77	Facility		$218.19	$393.76	$550.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.58 / $176.09 / $196.33	Professional		$133.58	$176.09	$196.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $243.08 / $367.53 / $459.41	Professional		$243.08	$367.53	$459.41
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $222.64 / $354.20 / $1,082.43	Professional		$222.64	$354.20	$1,082.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $201.85 / $261.19 / $465.52	Facility		$201.85	$261.19	$465.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $121.44 / $202.40 / $794.50	Professional		$121.44	$202.40	$794.50
Midlands Facility/Professional Facility Modifier Low / Median / High Price $242.88 / $371.12 / $449.78	Facility		$242.88	$371.12	$449.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $242.88 / $371.12 / $516.12	Professional		$242.88	$371.12	$516.12
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $202.40 / $202.40 / $361.28	Professional		$202.40	$202.40	$361.28
United Facility/Professional Professional Modifier Low / Median / High Price $121.44 / $121.44 / $511.87	Professional		$121.44	$121.44	$511.87
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $202.40 / $202.40 / $202.40	Professional		$202.40	$202.40	$202.40