Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $202.82 / $202.82 / $570.88	Facility		$202.82	$202.82	$570.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.26 / $162.26 / $202.82	Professional		$162.26	$162.26	$202.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $167.18 / $172.40 / $208.97	Professional		$167.18	$172.40	$208.97
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $297.30 / $348.60	Professional		$150.00	$297.30	$348.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $171.78 / $200.09 / $249.88	Facility		$171.78	$200.09	$249.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $202.82 / $202.82 / $353.19	Professional		$202.82	$202.82	$353.19
Midlands Facility/Professional Facility Modifier Low / Median / High Price $253.07 / $295.24 / $396.47	Facility		$253.07	$295.24	$396.47
Midlands Facility/Professional Professional Modifier Low / Median / High Price $183.99 / $183.99 / $183.99	Professional		$183.99	$183.99	$183.99
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $340.98 / $394.24 / $444.39	Professional		$340.98	$394.24	$444.39
United Facility/Professional Professional Modifier Low / Median / High Price $202.82 / $202.82 / $215.17	Professional		$202.82	$202.82	$215.17
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $169.08 / $169.08 / $169.08	Facility		$169.08	$169.08	$169.08
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $133.57 / $169.08 / $169.08	Professional		$133.57	$169.08	$169.08