Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $504.68 / $504.68 / $519.82	Facility		$504.68	$504.68	$519.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.54 / $98.09 / $194.04	Professional		$76.54	$98.09	$194.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.98 / $161.91 / $315.81	Professional		$89.98	$161.91	$315.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $82.39 / $112.35 / $316.60	Professional		$82.39	$112.35	$316.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $88.23 / $146.61 / $190.75	Facility		$88.23	$146.61	$190.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $105.29 / $170.77 / $509.49	Professional		$105.29	$170.77	$509.49
Midlands Facility/Professional Facility Modifier Low / Median / High Price $139.31 / $173.55 / $201.26	Facility		$139.31	$173.55	$201.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $118.14 / $173.55 / $221.30	Professional		$118.14	$173.55	$221.30
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $81.16 / $144.87 / $164.17	Professional		$81.16	$144.87	$164.17
United Facility/Professional Professional Modifier Low / Median / High Price $94.60 / $147.99 / $223.75	Professional		$94.60	$147.99	$223.75
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $97.33 / $123.20 / $144.90	Professional		$97.33	$123.20	$144.90