Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Facility		$245.47	$245.47	$245.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $309.03	Professional		$245.47	$245.47	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $323.59 / $398.11	Professional		$323.59	$323.59	$398.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $323.59 / $389.05	Professional		$151.36	$323.59	$389.05
Medica Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $309.03 / $616.60	Facility		$123.03	$309.03	$616.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $257.04 / $512.86	Professional		$218.78	$257.04	$512.86
Midlands Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $389.05 / $616.60	Professional		$263.03	$389.05	$616.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $426.58 / $426.58	Professional		$275.42	$426.58	$426.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $602.56 / $707.95	Professional		$524.81	$602.56	$707.95
United Facility/Professional Facility Modifier Low / Median / High Price $0.26 / $0.26 / $446.68	Facility		$0.26	$0.26	$446.68
United Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $263.03 / $316.23	Professional		$263.03	$263.03	$316.23
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $257.04 / $257.04	Professional		$199.53	$257.04	$257.04