Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $212.91 / $296.39 / $385.00	Professional		$212.91	$296.39	$385.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $270.92 / $577.72 / $722.33	Professional		$270.92	$577.72	$722.33
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $251.21 / $375.52 / $827.73	Professional		$251.21	$375.52	$827.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $256.08 / $372.48 / $611.41	Facility		$256.08	$372.48	$611.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $362.56 / $611.29 / $1,594.90	Professional		$362.56	$611.29	$1,594.90
Midlands Facility/Professional Facility Modifier Low / Median / High Price $478.08 / $577.72 / $657.62	Facility		$478.08	$577.72	$657.62
Midlands Facility/Professional Professional Modifier Low / Median / High Price $489.00 / $590.98 / $672.33	Professional		$489.00	$590.98	$672.33
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $232.01 / $407.64 / $492.92	Professional		$232.01	$407.64	$492.92
United Facility/Professional Professional Modifier Low / Median / High Price $280.14 / $490.53 / $692.70	Professional		$280.14	$490.53	$692.70
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $401.64 / $508.40 / $598.20	Professional		$401.64	$508.40	$598.20