Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $268.23 / $268.23 / $292.39	Facility		$268.23	$268.23	$292.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.73 / $130.76 / $206.40	Professional		$115.73	$130.76	$206.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.05 / $180.52 / $326.06	Professional		$173.05	$180.52	$326.06
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.30 / $263.02 / $395.56	Professional		$150.30	$263.02	$395.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $178.22 / $268.82 / $710.69	Facility		$178.22	$268.82	$710.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $150.30 / $270.54 / $1,210.74	Professional		$150.30	$270.54	$1,210.74
Midlands Facility/Professional Facility Modifier Low / Median / High Price $193.95 / $270.54 / $371.00	Facility		$193.95	$270.54	$371.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $195.39 / $300.02 / $424.22	Professional		$195.39	$300.02	$424.22
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $146.24 / $150.30 / $268.29	Professional		$146.24	$150.30	$268.29
United Facility/Professional Professional Modifier Low / Median / High Price $150.30 / $150.30 / $364.54	Professional		$150.30	$150.30	$364.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $150.30 / $150.30 / $150.30	Professional		$150.30	$150.30	$150.30