Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $281.84	Facility		$281.84	$281.84	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $213.80 / $467.74	Professional		$173.78	$213.80	$467.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $457.09 / $562.34	Professional		$288.40	$457.09	$562.34
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $251.19 / $537.03	Professional		$186.21	$251.19	$537.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $331.13 / $501.19	Facility		$208.93	$331.13	$501.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $416.87 / $1,380.38	Professional		$199.53	$416.87	$1,380.38
Midlands Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $446.68 / $562.34	Professional		$263.03	$446.68	$562.34
Midlands Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $426.58 / $549.54	Professional		$323.59	$426.58	$549.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $213.80 / $436.52	Professional		$102.33	$213.80	$436.52
United Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $323.59 / $426.58	Facility		$186.21	$323.59	$426.58
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $346.74 / $549.54	Professional		$194.98	$346.74	$549.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $416.87 / $489.78	Professional		$416.87	$416.87	$489.78