Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $607.22 / $607.22 / $641.45	Facility		$607.22	$607.22	$641.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.35 / $169.98 / $172.59	Professional		$131.35	$169.98	$172.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $183.96 / $183.96 / $488.88	Professional		$183.96	$183.96	$488.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $63.07 / $73.88 / $89.68	Professional		$63.07	$73.88	$89.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $117.29 / $211.08 / $513.67	Facility		$117.29	$211.08	$513.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $215.05 / $215.05 / $1,301.95	Professional		$215.05	$215.05	$1,301.95
Midlands Facility/Professional Facility Modifier Low / Median / High Price $99.25 / $324.60 / $488.88	Facility		$99.25	$324.60	$488.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $257.81 / $324.60 / $513.67	Professional		$257.81	$324.60	$513.67
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $304.39 / $304.39 / $304.39	Professional		$304.39	$304.39	$304.39
United Facility/Professional Professional Modifier Low / Median / High Price $215.05 / $215.05 / $236.56	Professional		$215.05	$215.05	$236.56
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $208.58 / $208.58 / $208.58	Facility		$208.58	$208.58	$208.58
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $164.78 / $208.58 / $208.58	Professional		$164.78	$208.58	$208.58