Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $170.43 / $207.90 / $256.61	Facility		$170.43	$207.90	$256.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.70 / $101.35 / $159.97	Professional		$89.70	$101.35	$159.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.81 / $150.32 / $1,028.36	Professional		$133.81	$150.32	$1,028.36
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $116.49 / $203.86 / $334.70	Professional		$116.49	$203.86	$334.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $110.67 / $198.65 / $556.67	Facility		$110.67	$198.65	$556.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $116.49 / $209.68 / $957.98	Professional		$116.49	$209.68	$957.98
Midlands Facility/Professional Facility Modifier Low / Median / High Price $150.32 / $209.68 / $294.00	Facility		$150.32	$209.68	$294.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $151.44 / $237.33 / $335.58	Professional		$151.44	$237.33	$335.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $113.34 / $116.49 / $207.93	Professional		$113.34	$116.49	$207.93
United Facility/Professional Professional Modifier Low / Median / High Price $116.49 / $136.29 / $459.34	Professional		$116.49	$136.29	$459.34
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $116.49 / $116.49 / $116.49	Professional		$116.49	$116.49	$116.49