Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $184.80 / $210.31 / $295.00	Facility		$184.80	$210.31	$295.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.69 / $125.06 / $197.41	Professional		$110.69	$125.06	$197.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.69 / $172.64 / $280.50	Professional		$154.69	$172.64	$280.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $143.75 / $251.56 / $433.22	Professional		$143.75	$251.56	$433.22
Medica Facility/Professional Facility Modifier Low / Median / High Price $170.46 / $215.63 / $610.00	Facility		$170.46	$215.63	$610.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $143.75 / $258.75 / $1,038.57	Professional		$143.75	$258.75	$1,038.57
Midlands Facility/Professional Facility Modifier Low / Median / High Price $185.50 / $258.75 / $318.00	Facility		$185.50	$258.75	$318.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $186.88 / $263.58 / $370.49	Professional		$186.88	$263.58	$370.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $139.87 / $143.75 / $256.58	Professional		$139.87	$143.75	$256.58
United Facility/Professional Professional Modifier Low / Median / High Price $143.75 / $148.06 / $384.89	Professional		$143.75	$148.06	$384.89
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $143.75 / $143.75 / $143.75	Professional		$143.75	$143.75	$143.75