Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.99 / $154.84 / $245.52	Facility		$87.99	$154.84	$245.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.53 / $207.85 / $622.76	Professional		$130.53	$207.85	$622.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.07 / $304.20 / $380.25	Professional		$199.07	$304.20	$380.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $160.91 / $250.10 / $459.69	Professional		$160.91	$250.10	$459.69
Medica Facility/Professional Facility Modifier Low / Median / High Price $156.40 / $313.45 / $383.33	Facility		$156.40	$313.45	$383.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $210.14 / $323.06 / $1,215.07	Professional		$210.14	$323.06	$1,215.07
Midlands Facility/Professional Facility Modifier Low / Median / High Price $250.85 / $330.59 / $386.95	Facility		$250.85	$330.59	$386.95
Midlands Facility/Professional Professional Modifier Low / Median / High Price $247.26 / $326.77 / $497.20	Professional		$247.26	$326.77	$497.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $163.38 / $282.74 / $345.80	Professional		$163.38	$282.74	$345.80
United Facility/Professional Professional Modifier Low / Median / High Price $196.82 / $233.98 / $452.74	Professional		$196.82	$233.98	$452.74
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $225.07 / $242.10 / $293.39	Professional		$225.07	$242.10	$293.39