Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $267.33 / $267.33 / $267.33	Facility		$267.33	$267.33	$267.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.48 / $110.36 / $169.88	Professional		$93.48	$110.36	$169.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,478.00 / $1,478.00 / $1,863.00	Facility		$1,478.00	$1,478.00	$1,863.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.26 / $192.57 / $269.02	Professional		$99.26	$192.57	$269.02
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $98.49 / $169.78 / $376.56	Professional		$98.49	$169.78	$376.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $118.04 / $214.28 / $263.69	Facility		$118.04	$214.28	$263.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $117.54 / $205.44 / $1,356.40	Professional		$117.54	$205.44	$1,356.40
Midlands Facility/Professional Facility Modifier Low / Median / High Price $157.55 / $235.77 / $259.27	Facility		$157.55	$235.77	$259.27
Midlands Facility/Professional Professional Modifier Low / Median / High Price $157.55 / $211.43 / $268.02	Professional		$157.55	$211.43	$268.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $91.69 / $165.58 / $201.88	Professional		$91.69	$165.58	$201.88
United Facility/Professional Professional Modifier Low / Median / High Price $107.19 / $163.54 / $270.51	Professional		$107.19	$163.54	$270.51
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $147.97 / $187.30 / $229.20	Professional		$147.97	$187.30	$229.20