Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $197.65 / $380.25 / $695.39	Facility		$197.65	$380.25	$695.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $197.83 / $197.83 / $217.62	Professional		$197.83	$197.83	$217.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $237.02 / $237.02 / $237.02	Facility		$237.02	$237.02	$237.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $197.74 / $214.63 / $285.74	Professional		$197.74	$214.63	$285.74
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $141.11 / $237.24 / $584.52	Professional		$141.11	$237.24	$584.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $197.65 / $226.79 / $358.73	Facility		$197.65	$226.79	$358.73
Medica Facility/Professional Professional Modifier Low / Median / High Price $197.65 / $220.03 / $855.93	Professional		$197.65	$220.03	$855.93
Midlands Facility/Professional Facility Modifier Low / Median / High Price $232.89 / $296.47 / $379.02	Facility		$232.89	$296.47	$379.02
Midlands Facility/Professional Professional Modifier Low / Median / High Price $232.89 / $253.51 / $298.88	Professional		$232.89	$253.51	$298.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $201.65 / $392.03 / $413.25	Professional		$201.65	$392.03	$413.25
United Facility/Professional Professional Modifier Low / Median / High Price $197.83 / $203.76 / $235.42	Professional		$197.83	$203.76	$235.42
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $216.29 / $216.29 / $216.29	Facility		$216.29	$216.29	$216.29
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $170.87 / $216.29 / $216.29	Professional		$170.87	$216.29	$216.29