Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $253.15 / $253.15 / $568.74	Facility		$253.15	$253.15	$568.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $253.15 / $258.64 / $459.23	Professional		$253.15	$258.64	$459.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $253.61 / $258.64 / $323.61	Professional		$253.61	$258.64	$323.61
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $185.57 / $258.64 / $447.15	Professional		$185.57	$258.64	$447.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $194.99 / $258.52 / $436.90	Facility		$194.99	$258.52	$436.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $258.52 / $284.37 / $6,942.60	Professional		$258.52	$284.37	$6,942.60
Midlands Facility/Professional Facility Modifier Low / Median / High Price $285.64 / $373.40 / $449.69	Facility		$285.64	$373.40	$449.69
Midlands Facility/Professional Professional Modifier Low / Median / High Price $166.39 / $298.72 / $387.77	Professional		$166.39	$298.72	$387.77
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $258.64 / $512.13 / $540.28	Professional		$258.64	$512.13	$540.28
United Facility/Professional Professional Modifier Low / Median / High Price $258.64 / $271.57 / $307.77	Professional		$258.64	$271.57	$307.77
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $282.89 / $282.89 / $282.89	Facility		$282.89	$282.89	$282.89
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $223.49 / $282.89 / $282.89	Professional		$223.49	$282.89	$282.89