Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.01 / $292.37 / $638.63	Facility		$162.01	$292.37	$638.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.72 / $130.75 / $206.39	Professional		$115.72	$130.75	$206.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $184.07 / $273.52 / $341.90	Professional		$184.07	$273.52	$341.90
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.29 / $272.02 / $550.13	Professional		$150.29	$272.02	$550.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $150.29 / $256.26 / $471.16	Facility		$150.29	$256.26	$471.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $150.29 / $225.44 / $795.72	Professional		$150.29	$225.44	$795.72
Midlands Facility/Professional Facility Modifier Low / Median / High Price $193.94 / $306.20 / $471.16	Facility		$193.94	$306.20	$471.16
Midlands Facility/Professional Professional Modifier Low / Median / High Price $193.94 / $306.20 / $432.94	Professional		$193.94	$306.20	$432.94
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $146.22 / $150.29 / $268.27	Professional		$146.22	$150.29	$268.27
United Facility/Professional Professional Modifier Low / Median / High Price $150.29 / $150.29 / $364.04	Professional		$150.29	$150.29	$364.04
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $150.29 / $150.29 / $150.29	Professional		$150.29	$150.29	$150.29