Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $262.99 / $504.96 / $715.64	Facility		$262.99	$504.96	$715.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.57 / $202.50 / $255.10	Professional		$173.57	$202.50	$255.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $315.85 / $477.85 / $597.30	Professional		$315.85	$477.85	$597.30
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $289.29 / $460.23 / $582.26	Professional		$289.29	$460.23	$582.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $262.99 / $339.37 / $673.25	Facility		$262.99	$339.37	$673.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $157.79 / $236.69 / $988.12	Professional		$157.79	$236.69	$988.12
Midlands Facility/Professional Facility Modifier Low / Median / High Price $315.58 / $368.19 / $576.37	Facility		$315.58	$368.19	$576.37
Midlands Facility/Professional Professional Modifier Low / Median / High Price $315.58 / $480.94 / $686.40	Professional		$315.58	$480.94	$686.40
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $262.99 / $262.99 / $262.99	Facility		$262.99	$262.99	$262.99
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $262.99 / $262.99 / $469.44	Professional		$262.99	$262.99	$469.44
United Facility/Professional Professional Modifier Low / Median / High Price $157.79 / $157.79 / $573.32	Professional		$157.79	$157.79	$573.32
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $262.99 / $262.99 / $262.99	Professional		$262.99	$262.99	$262.99