Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $293.83 / $299.74 / $369.39	Facility		$293.83	$299.74	$369.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.84 / $155.96 / $378.40	Professional		$119.84	$155.96	$378.40
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $261.39 / $261.39 / $265.89	Professional	25	$261.39	$261.39	$265.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.90 / $234.32 / $325.47	Professional		$147.90	$234.32	$325.47
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $119.84 / $156.44 / $404.60	Professional		$119.84	$156.44	$404.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $126.00 / $213.99 / $304.58	Facility		$126.00	$213.99	$304.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $142.00 / $242.44 / $828.70	Professional		$142.00	$242.44	$828.70
Midlands Facility/Professional Facility Modifier Low / Median / High Price $188.75 / $241.14 / $387.50	Facility		$188.75	$241.14	$387.50
Midlands Facility/Professional Professional Modifier Low / Median / High Price $188.75 / $241.14 / $387.50	Professional		$188.75	$241.14	$387.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $119.84 / $213.91 / $308.33	Professional		$119.84	$213.91	$308.33
United Facility/Professional Professional Modifier Low / Median / High Price $135.54 / $190.50 / $368.62	Professional		$135.54	$190.50	$368.62
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $189.30 / $224.76 / $284.50	Professional		$189.30	$224.76	$284.50