Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $212.28 / $257.52 / $343.36	Facility		$212.28	$257.52	$343.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $123.32 / $180.72	Professional		$89.34	$123.32	$180.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.00 / $159.90 / $315.68	Professional		$101.00	$159.90	$315.68
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $92.35 / $132.51 / $276.83	Professional		$92.35	$132.51	$276.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $102.20 / $166.76 / $266.02	Facility		$102.20	$166.76	$266.02
Medica Facility/Professional Professional Modifier Low / Median / High Price $136.63 / $294.85 / $817.07	Professional		$136.63	$294.85	$817.07
Midlands Facility/Professional Facility Modifier Low / Median / High Price $208.59 / $254.55 / $298.58	Facility		$208.59	$254.55	$298.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $208.59 / $254.55 / $337.48	Professional		$208.59	$254.55	$337.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $104.02 / $148.69 / $231.05	Professional		$104.02	$148.69	$231.05
United Facility/Professional Professional Modifier Low / Median / High Price $126.62 / $209.22 / $351.74	Professional		$126.62	$209.22	$351.74
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $173.00 / $203.50 / $247.70	Professional		$173.00	$203.50	$247.70