Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $187.21 / $337.84 / $706.77	Facility		$187.21	$337.84	$706.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.62 / $151.08 / $168.45	Professional		$114.62	$151.08	$168.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.57 / $315.30 / $394.13	Professional		$208.57	$315.30	$394.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $173.66 / $314.32 / $516.33	Professional		$173.66	$314.32	$516.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $173.66 / $283.61 / $544.41	Facility		$173.66	$283.61	$544.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $173.66 / $249.93 / $880.65	Professional		$173.66	$249.93	$880.65
Midlands Facility/Professional Facility Modifier Low / Median / High Price $224.10 / $338.86 / $544.41	Facility		$224.10	$338.86	$544.41
Midlands Facility/Professional Professional Modifier Low / Median / High Price $224.10 / $338.86 / $479.14	Professional		$224.10	$338.86	$479.14
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $168.97 / $173.66 / $309.98	Professional		$168.97	$173.66	$309.98
United Facility/Professional Professional Modifier Low / Median / High Price $173.66 / $173.66 / $347.32	Professional		$173.66	$173.66	$347.32
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $173.66 / $173.66 / $173.66	Professional		$173.66	$173.66	$173.66