Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.71 / $228.25 / $308.89	Facility		$190.71	$228.25	$308.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.01 / $153.35 / $554.00	Professional		$115.01	$153.35	$554.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.06 / $252.21 / $370.20	Professional		$135.06	$252.21	$370.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $129.19 / $227.97 / $501.45	Professional		$129.19	$227.97	$501.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $154.62 / $258.22 / $344.83	Facility		$154.62	$258.22	$344.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $194.67 / $320.88 / $1,111.43	Professional		$194.67	$320.88	$1,111.43
Midlands Facility/Professional Facility Modifier Low / Median / High Price $268.12 / $284.00 / $529.13	Facility		$268.12	$284.00	$529.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $252.21 / $303.85 / $529.13	Professional		$252.21	$303.85	$529.13
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $135.94 / $135.94 / $1,617.84	Facility		$135.94	$135.94	$1,617.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $114.50 / $169.71 / $373.00	Professional		$114.50	$169.71	$373.00
United Facility/Professional Professional Modifier Low / Median / High Price $179.31 / $238.91 / $410.92	Professional		$179.31	$238.91	$410.92
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $160.50 / $188.80 / $227.70	Professional		$160.50	$188.80	$227.70