Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.43 / $540.07 / $823.49	Facility		$177.43	$540.07	$823.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.73 / $263.27 / $293.54	Professional		$199.73	$263.27	$293.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $347.75 / $549.66 / $687.07	Professional		$347.75	$549.66	$687.07
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $103.10 / $302.62 / $529.59	Professional		$103.10	$302.62	$529.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $71.19 / $302.62 / $623.40	Facility		$71.19	$302.62	$623.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $36.57 / $181.57 / $789.84	Professional		$36.57	$181.57	$789.84
Midlands Facility/Professional Facility Modifier Low / Median / High Price $92.79 / $393.41 / $663.22	Facility		$92.79	$393.41	$663.22
Midlands Facility/Professional Professional Modifier Low / Median / High Price $76.51 / $363.44 / $623.40	Professional		$76.51	$363.44	$623.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $294.45 / $302.62 / $540.17	Professional		$294.45	$302.62	$540.17
United Facility/Professional Professional Modifier Low / Median / High Price $58.33 / $181.57 / $311.70	Professional		$58.33	$181.57	$311.70
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $302.62 / $302.62 / $302.62	Professional		$302.62	$302.62	$302.62