Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Facility		$223.87	$223.87	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $151.36 / $524.81	Professional		$95.50	$151.36	$524.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $208.93 / $295.12	Professional		$109.65	$208.93	$295.12
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $295.12 / $1,258.93	Professional		$114.82	$295.12	$1,258.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $158.49 / $269.15	Facility		$97.72	$158.49	$269.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $186.21 / $1,071.52	Professional		$123.03	$186.21	$1,071.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $239.88 / $316.23	Professional		$173.78	$239.88	$316.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $251.19 / $323.59	Professional		$204.17	$251.19	$323.59
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $190.55 / $239.88	Professional		$107.15	$190.55	$239.88
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $154.88 / $269.15	Professional		$120.23	$154.88	$269.15
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $239.88 / $239.88	Professional		$190.55	$239.88	$239.88