Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $281.84 / $426.58	Facility		$25.12	$281.84	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $223.87 / $630.96	Professional		$138.04	$223.87	$630.96
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $169.82 / $331.13 / $741.31	Professional	25	$169.82	$331.13	$741.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $269.15 / $512.86	Professional		$162.18	$269.15	$512.86
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $281.84 / $489.78	Professional		$169.82	$281.84	$489.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $208.93 / $389.05	Facility		$144.54	$208.93	$389.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $316.23 / $1,380.38	Professional		$190.55	$316.23	$1,380.38
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $323.59 / $588.84 / $660.69	Professional	25	$323.59	$588.84	$660.69
Midlands Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $354.81 / $489.78	Professional		$269.15	$354.81	$489.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $371.54 / $549.54	Professional		$239.88	$371.54	$549.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $302.00 / $501.19	Professional		$169.82	$302.00	$501.19
United Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $251.19	Facility		$208.93	$208.93	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $223.87 / $380.19	Professional		$162.18	$223.87	$380.19
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $257.04 / $316.23	Professional		$204.17	$257.04	$316.23