Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $288.40 / $436.52	Facility		$114.82	$288.40	$436.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $134.90 / $234.42	Professional		$104.71	$134.90	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $288.40 / $363.08	Professional		$288.40	$288.40	$363.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $269.15 / $501.19	Professional		$151.36	$269.15	$501.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $234.42 / $467.74	Facility		$151.36	$234.42	$467.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $245.47 / $812.83	Professional		$151.36	$245.47	$812.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $194.98	Professional		$181.97	$181.97	$194.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $162.18 / $323.59	Professional		$147.91	$162.18	$323.59
United Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $346.74	Facility		$151.36	$151.36	$346.74
United Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $154.88 / $371.54	Professional		$151.36	$154.88	$371.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Professional		$151.36	$151.36	$151.36