Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $302.00 / $524.81	Facility		$263.03	$302.00	$524.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $263.03 / $446.68	Professional		$257.04	$263.03	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $263.03 / $331.13	Professional		$263.03	$263.03	$331.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $489.78 / $616.60	Professional		$218.78	$489.78	$616.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $288.40 / $436.52	Facility		$257.04	$288.40	$436.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $281.84 / $1,096.48	Professional		$257.04	$281.84	$1,096.48
Midlands Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $323.59 / $380.19	Professional		$295.12	$323.59	$380.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $323.59 / $776.25	Professional		$229.09	$323.59	$776.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $467.74 / $562.34	Professional		$281.84	$467.74	$562.34
United Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $263.03 / $263.03	Facility		$263.03	$263.03	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $263.03 / $309.03	Professional		$263.03	$263.03	$309.03
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $281.84	Facility		$281.84	$281.84	$281.84
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $281.84 / $281.84	Professional		$223.87	$281.84	$281.84