Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $407.38 / $660.69	Facility		$131.83	$407.38	$660.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $151.36 / $269.15	Professional		$120.23	$151.36	$269.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $416.87	Professional		$331.13	$331.13	$416.87
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $251.19 / $436.52	Professional		$173.78	$251.19	$436.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $269.15 / $537.03	Facility		$173.78	$269.15	$537.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $288.40 / $933.25	Professional		$173.78	$288.40	$933.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $223.87 / $676.08	Professional		$208.93	$223.87	$676.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $186.21 / $371.54	Professional		$169.82	$186.21	$371.54
United Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $398.11	Facility		$173.78	$173.78	$398.11
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $177.83 / $426.58	Professional		$173.78	$177.83	$426.58
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Professional		$173.78	$173.78	$173.78