Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $282.88 / $504.84 / $769.78	Facility		$282.88	$504.84	$769.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.68 / $217.82 / $388.47	Professional		$103.68	$217.82	$388.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $339.73 / $514.41 / $643.01	Professional		$339.73	$514.41	$643.01
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $311.17 / $495.04 / $886.77	Professional		$311.17	$495.04	$886.77
Medica Facility/Professional Facility Modifier Low / Median / High Price $268.74 / $339.73 / $650.62	Facility		$268.74	$339.73	$650.62
Medica Facility/Professional Professional Modifier Low / Median / High Price $169.73 / $282.88 / $912.88	Professional		$169.73	$282.88	$912.88
Midlands Facility/Professional Facility Modifier Low / Median / High Price $339.46 / $518.70 / $628.64	Facility		$339.46	$518.70	$628.64
Midlands Facility/Professional Professional Modifier Low / Median / High Price $339.46 / $518.70 / $659.11	Professional		$339.46	$518.70	$659.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $282.88 / $282.88 / $504.94	Professional		$282.88	$282.88	$504.94
United Facility/Professional Professional Modifier Low / Median / High Price $169.73 / $169.73 / $579.20	Professional		$169.73	$169.73	$579.20
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $282.88 / $282.88 / $282.88	Professional		$282.88	$282.88	$282.88