Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.07 / $404.56 / $463.63	Facility		$245.07	$404.56	$463.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.54 / $185.78 / $256.68	Professional		$93.54	$185.78	$256.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $237.17 / $363.57 / $439.96	Professional		$237.17	$363.57	$439.96
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $154.99 / $209.17 / $1,689.37	Professional		$154.99	$209.17	$1,689.37
Medica Facility/Professional Facility Modifier Low / Median / High Price $154.99 / $273.30 / $698.44	Facility		$154.99	$273.30	$698.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $171.95 / $413.15 / $1,125.58	Professional		$171.95	$413.15	$1,125.58
Midlands Facility/Professional Facility Modifier Low / Median / High Price $237.17 / $415.01 / $448.95	Facility		$237.17	$415.01	$448.95
Midlands Facility/Professional Professional Modifier Low / Median / High Price $237.17 / $415.01 / $448.95	Professional		$237.17	$415.01	$448.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $155.50 / $652.13 / $706.11	Professional		$155.50	$652.13	$706.11
United Facility/Professional Professional Modifier Low / Median / High Price $206.49 / $388.69 / $642.94	Professional		$206.49	$388.69	$642.94
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $116.37 / $147.30 / $147.30	Professional		$116.37	$147.30	$147.30