Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $186.68 / $336.88 / $735.90	Facility		$186.68	$336.88	$735.90
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 $212.10 / $314.64 / $393.31	Professional		$212.10	$314.64	$393.31
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $173.17 / $303.05 / $522.90	Professional		$173.17	$303.05	$522.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $173.17 / $295.30 / $542.89	Facility		$173.17	$295.30	$542.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $173.17 / $259.76 / $916.93	Professional		$173.17	$259.76	$916.93
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 / $352.81 / $498.86	Professional		$223.46	$352.81	$498.86
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 / $405.39	Professional		$173.17	$173.17	$405.39
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $173.17 / $173.17 / $173.17	Professional		$173.17	$173.17	$173.17