Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $189.50 / $368.67 / $368.67	Facility		$189.50	$368.67	$368.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.30 / $174.67 / $564.00	Professional		$137.30	$174.67	$564.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $157.24 / $260.77 / $260.77	Professional	25	$157.24	$260.77	$260.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.60 / $240.66 / $386.75	Professional		$147.60	$240.66	$386.75
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $133.44 / $156.15 / $393.12	Professional		$133.44	$156.15	$393.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $171.40 / $277.48 / $366.48	Facility		$171.40	$277.48	$366.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $172.87 / $258.56 / $1,045.69	Professional		$172.87	$258.56	$1,045.69
Midlands Facility/Professional Facility Modifier Low / Median / High Price $206.40 / $240.66 / $386.75	Facility		$206.40	$240.66	$386.75
Midlands Facility/Professional Professional Modifier Low / Median / High Price $209.79 / $270.91 / $386.75	Professional		$209.79	$270.91	$386.75
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $158.66 / $278.73 / $309.80	Professional		$158.66	$278.73	$309.80
United Facility/Professional Professional Modifier Low / Median / High Price $164.23 / $223.03 / $377.74	Professional		$164.23	$223.03	$377.74
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $185.49 / $234.80 / $234.80	Professional		$185.49	$234.80	$234.80