Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $186.68 / $336.88 / $632.58	Facility		$186.68	$336.88	$632.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.29 / $150.66 / $167.97	Professional		$114.29	$150.66	$167.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $207.98 / $314.64 / $393.31	Professional		$207.98	$314.64	$393.31
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $173.17 / $285.73 / $399.86	Professional		$173.17	$285.73	$399.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $173.17 / $253.84 / $542.89	Facility		$173.17	$253.84	$542.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $173.17 / $225.08 / $788.21	Professional		$173.17	$225.08	$788.21
Midlands Facility/Professional Facility Modifier Low / Median / High Price $223.46 / $352.81 / $542.89	Facility		$223.46	$352.81	$542.89
Midlands Facility/Professional Professional Modifier Low / Median / High Price $223.46 / $343.00 / $451.97	Professional		$223.46	$343.00	$451.97
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $168.49 / $173.17 / $309.11	Professional		$168.49	$173.17	$309.11
United Facility/Professional Professional Modifier Low / Median / High Price $173.17 / $173.17 / $419.48	Professional		$173.17	$173.17	$419.48
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $173.17 / $173.17 / $173.17	Professional		$173.17	$173.17	$173.17