Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $129.83 / $242.97 / $804.09	Facility		$129.83	$242.97	$804.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.75 / $167.45 / $226.80	Professional		$93.75	$167.45	$226.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.14 / $289.70 / $354.38	Professional		$126.14	$289.70	$354.38
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $87.59 / $153.77 / $299.25	Professional		$87.59	$153.77	$299.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $102.78 / $213.99 / $443.14	Facility		$102.78	$213.99	$443.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $213.09 / $368.91 / $917.85	Professional		$213.09	$368.91	$917.85
Midlands Facility/Professional Facility Modifier Low / Median / High Price $126.14 / $220.38 / $332.66	Facility		$126.14	$220.38	$332.66
Midlands Facility/Professional Professional Modifier Low / Median / High Price $139.25 / $304.88 / $413.43	Professional		$139.25	$304.88	$413.43
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $126.90 / $492.37 / $565.11	Professional		$126.90	$492.37	$565.11
United Facility/Professional Professional Modifier Low / Median / High Price $207.17 / $337.18 / $539.49	Professional		$207.17	$337.18	$539.49
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $198.37 / $251.10 / $251.10	Professional		$198.37	$251.10	$251.10