Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $245.47 / $416.87	Facility		$208.93	$245.47	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $213.80 / $331.13	Professional		$208.93	$213.80	$331.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $213.80 / $269.15	Professional		$208.93	$213.80	$269.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $281.84 / $389.05	Professional		$177.83	$281.84	$389.05
Medica Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $229.09 / $346.74	Facility		$204.17	$229.09	$346.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $229.09 / $912.01	Professional		$204.17	$229.09	$912.01
Midlands Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $263.03 / $316.23	Professional		$245.47	$263.03	$316.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $251.19 / $269.15	Professional		$251.19	$251.19	$269.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $371.54 / $457.09	Professional		$229.09	$371.54	$457.09
United Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Facility		$208.93	$208.93	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $251.19	Professional		$208.93	$208.93	$251.19
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $229.09 / $229.09	Facility		$229.09	$229.09	$229.09
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $229.09 / $229.09	Professional		$177.83	$229.09	$229.09