Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $183.59 / $274.02 / $816.20	Facility		$183.59	$274.02	$816.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.63 / $109.18 / $172.33	Professional		$96.63	$109.18	$172.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $152.66 / $227.83 / $284.77	Professional		$152.66	$227.83	$284.77
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $125.49 / $237.91 / $462.27	Professional		$125.49	$237.91	$462.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $125.49 / $212.53 / $459.93	Facility		$125.49	$212.53	$459.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $125.49 / $187.29 / $539.26	Professional		$125.49	$187.29	$539.26
Midlands Facility/Professional Facility Modifier Low / Median / High Price $161.93 / $253.94 / $393.41	Facility		$161.93	$253.94	$393.41
Midlands Facility/Professional Professional Modifier Low / Median / High Price $161.93 / $253.94 / $359.06	Professional		$161.93	$253.94	$359.06
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $122.10 / $125.49 / $224.00	Professional		$122.10	$125.49	$224.00
United Facility/Professional Professional Modifier Low / Median / High Price $125.49 / $125.49 / $301.91	Professional		$125.49	$125.49	$301.91
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $125.49 / $125.49 / $125.49	Professional		$125.49	$125.49	$125.49