Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.80 / $199.37 / $265.81	Facility		$162.80	$199.37	$265.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.38 / $171.64 / $577.13	Professional		$119.38	$171.64	$577.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.98 / $195.76 / $334.60	Professional		$119.98	$195.76	$334.60
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $127.60 / $209.01 / $495.00	Professional		$127.60	$209.01	$495.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $151.53 / $252.02 / $317.16	Facility		$151.53	$252.02	$317.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $179.44 / $249.59 / $1,010.75	Professional		$179.44	$249.59	$1,010.75
Midlands Facility/Professional Facility Modifier Low / Median / High Price $248.00 / $276.01 / $434.21	Facility		$248.00	$276.01	$434.21
Midlands Facility/Professional Professional Modifier Low / Median / High Price $179.06 / $259.41 / $434.21	Professional		$179.06	$259.41	$434.21
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $132.63 / $205.50 / $318.10	Professional		$132.63	$205.50	$318.10
United Facility/Professional Professional Modifier Low / Median / High Price $170.14 / $210.93 / $378.79	Professional		$170.14	$210.93	$378.79
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $153.66 / $165.30 / $200.40	Professional		$153.66	$165.30	$200.40