Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.64 / $360.28 / $503.95	Facility		$199.64	$360.28	$503.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $122.23 / $161.12 / $282.61	Professional		$122.23	$161.12	$282.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $222.42 / $336.84 / $421.06	Professional		$222.42	$336.84	$421.06
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $203.72 / $324.10 / $630.75	Professional		$203.72	$324.10	$630.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $179.00 / $222.42 / $425.96	Facility		$179.00	$222.42	$425.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $111.12 / $185.20 / $597.66	Professional		$111.12	$185.20	$597.66
Midlands Facility/Professional Facility Modifier Low / Median / High Price $222.24 / $339.58 / $411.58	Facility		$222.24	$339.58	$411.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $222.24 / $339.58 / $431.52	Professional		$222.24	$339.58	$431.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $185.20 / $185.20 / $330.58	Professional		$185.20	$185.20	$330.58
United Facility/Professional Professional Modifier Low / Median / High Price $111.12 / $111.12 / $342.62	Professional		$111.12	$111.12	$342.62
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $185.20 / $185.20 / $185.20	Professional		$185.20	$185.20	$185.20