Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $267.87 / $267.87 / $520.55	Facility		$267.87	$267.87	$520.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $236.62 / $236.62 / $538.10	Professional		$236.62	$236.62	$538.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $236.62 / $256.70 / $344.51	Professional		$236.62	$256.70	$344.51
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $165.85 / $260.27 / $513.37	Professional		$165.85	$260.27	$513.37
Medica Facility/Professional Facility Modifier Low / Median / High Price $236.62 / $267.87 / $399.89	Facility		$236.62	$267.87	$399.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $236.62 / $263.41 / $1,029.23	Professional		$236.62	$263.41	$1,029.23
Midlands Facility/Professional Facility Modifier Low / Median / High Price $279.74 / $354.92 / $475.19	Facility		$279.74	$354.92	$475.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $279.74 / $304.14 / $535.99	Professional		$279.74	$304.14	$535.99
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $240.16 / $468.90 / $494.28	Professional		$240.16	$468.90	$494.28
United Facility/Professional Professional Modifier Low / Median / High Price $236.62 / $236.62 / $281.58	Professional		$236.62	$236.62	$281.58
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $258.94 / $258.94 / $258.94	Facility		$258.94	$258.94	$258.94
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $204.56 / $258.94 / $258.94	Professional		$204.56	$258.94	$258.94