Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $181.97 / $181.97	Facility		$181.97	$181.97	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $398.11	Professional		$87.10	$87.10	$398.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $489.78 / $562.34	Professional		$288.40	$489.78	$562.34
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $575.44 / $758.58	Professional		$245.47	$575.44	$758.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $91.20 / $512.86	Facility		$87.10	$91.20	$512.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $616.60 / $616.60	Professional		$380.19	$616.60	$616.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $489.78 / $489.78	Professional		$489.78	$489.78	$489.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $398.11 / $489.78	Professional		$398.11	$398.11	$489.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $363.08	Professional		$363.08	$363.08	$363.08
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $371.54 / $380.19	Professional		$295.12	$371.54	$380.19