Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $251.15 / $251.15 / $273.77	Facility		$251.15	$251.15	$273.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.36 / $122.44 / $193.26	Professional		$108.36	$122.44	$193.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.90 / $172.36 / $311.82	Professional		$161.90	$172.36	$311.82
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $140.72 / $246.28 / $378.04	Professional		$140.72	$246.28	$378.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $133.69 / $239.97 / $672.24	Facility		$133.69	$239.97	$672.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $140.72 / $253.31 / $1,157.24	Professional		$140.72	$253.31	$1,157.24
Midlands Facility/Professional Facility Modifier Low / Median / High Price $181.61 / $253.31 / $354.00	Facility		$181.61	$253.31	$354.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $182.95 / $286.70 / $405.38	Professional		$182.95	$286.70	$405.38
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $136.93 / $140.72 / $251.20	Professional		$136.93	$140.72	$251.20
United Facility/Professional Professional Modifier Low / Median / High Price $140.72 / $144.94 / $376.80	Professional		$140.72	$144.94	$376.80
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $140.72 / $140.72 / $140.72	Professional		$140.72	$140.72	$140.72