Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $203.28 / $366.85 / $763.91	Facility		$203.28	$366.85	$763.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $124.46 / $164.06 / $182.91	Professional		$124.46	$164.06	$182.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $226.48 / $342.72 / $428.40	Professional		$226.48	$342.72	$428.40
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $188.57 / $364.44 / $613.59	Professional		$188.57	$364.44	$613.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $188.57 / $306.54 / $591.16	Facility		$188.57	$306.54	$591.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $188.57 / $270.13 / $951.88	Professional		$188.57	$270.13	$951.88
Midlands Facility/Professional Facility Modifier Low / Median / High Price $243.33 / $366.26 / $591.16	Facility		$243.33	$366.26	$591.16
Midlands Facility/Professional Professional Modifier Low / Median / High Price $243.33 / $366.26 / $517.88	Professional		$243.33	$366.26	$517.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $183.48 / $188.57 / $336.60	Professional		$183.48	$188.57	$336.60
United Facility/Professional Professional Modifier Low / Median / High Price $188.57 / $188.57 / $441.44	Professional		$188.57	$188.57	$441.44
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $188.57 / $188.57 / $188.57	Professional		$188.57	$188.57	$188.57