Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $280.83 / $506.79 / $708.89	Facility		$280.83	$506.79	$708.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $200.59 / $200.59 / $252.69	Professional		$200.59	$200.59	$252.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $299.43 / $473.28 / $591.60	Professional		$299.43	$473.28	$591.60
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $221.43 / $390.75 / $527.95	Professional		$221.43	$390.75	$527.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $200.59 / $336.15 / $1,022.56	Facility		$200.59	$336.15	$1,022.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $156.30 / $260.50 / $840.66	Professional		$156.30	$260.50	$840.66
Midlands Facility/Professional Facility Modifier Low / Median / High Price $312.87 / $477.65 / $666.88	Facility		$312.87	$477.65	$666.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $312.60 / $477.65 / $664.28	Professional		$312.60	$477.65	$664.28
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $260.50 / $260.50 / $464.99	Professional		$260.50	$260.50	$464.99
United Facility/Professional Facility Modifier Low / Median / High Price $390.75 / $390.75 / $390.75	Facility		$390.75	$390.75	$390.75
United Facility/Professional Professional Modifier Low / Median / High Price $156.30 / $156.30 / $599.15	Professional		$156.30	$156.30	$599.15
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $205.80 / $260.50 / $260.50	Professional		$205.80	$260.50	$260.50