Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.65 / $201.27 / $222.72	Professional		$74.65	$201.27	$222.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $284.52 / $308.25 / $385.31	Professional		$284.52	$308.25	$385.31
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $265.89 / $293.14 / $481.28	Professional		$265.89	$293.14	$481.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $181.70 / $285.33 / $350.55	Facility		$181.70	$285.33	$350.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $130.11 / $169.85 / $687.29	Professional		$130.11	$169.85	$687.29
Midlands Facility/Professional Facility Modifier Low / Median / High Price $264.83 / $292.49 / $382.70	Facility		$264.83	$292.49	$382.70
Midlands Facility/Professional Professional Modifier Low / Median / High Price $235.61 / $303.95 / $437.03	Professional		$235.61	$303.95	$437.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $134.30 / $399.70 / $523.90	Professional		$134.30	$399.70	$523.90
United Facility/Professional Professional Modifier Low / Median / High Price $124.87 / $132.65 / $227.72	Professional		$124.87	$132.65	$227.72
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $239.31 / $239.31 / $239.31	Facility		$239.31	$239.31	$239.31
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $189.05 / $239.31 / $239.31	Professional		$189.05	$239.31	$239.31