Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $281.84	Facility		$275.42	$275.42	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $213.80 / $524.81	Professional		$186.21	$213.80	$524.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $457.09 / $549.54	Professional		$295.12	$457.09	$549.54
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $302.00 / $794.33	Professional		$204.17	$302.00	$794.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $309.03 / $512.86	Facility		$208.93	$309.03	$512.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $478.63 / $1,288.25	Professional		$269.15	$478.63	$1,288.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $512.86 / $537.03	Professional		$407.38	$512.86	$537.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $537.03 / $831.76	Professional		$478.63	$537.03	$831.76
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $331.13 / $478.63	Professional		$186.21	$331.13	$478.63
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $354.81 / $562.34	Professional		$223.87	$354.81	$562.34
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $416.87 / $489.78	Professional		$407.38	$416.87	$489.78