Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $186.21 / $346.74	Facility		$173.78	$186.21	$346.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $177.83 / $295.12	Professional		$173.78	$177.83	$295.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $177.83 / $218.78	Professional		$173.78	$177.83	$218.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $199.53 / $354.81	Professional		$147.91	$199.53	$354.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $177.83 / $281.84	Facility		$128.82	$177.83	$281.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $190.55 / $2,951.21	Professional		$165.96	$190.55	$2,951.21
Midlands Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $199.53 / $257.04	Professional		$138.04	$199.53	$257.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $213.80 / $323.59	Professional		$109.65	$213.80	$323.59
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $309.03 / $371.54	Professional		$186.21	$309.03	$371.54
United Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Facility		$173.78	$173.78	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $208.93	Professional		$173.78	$173.78	$208.93
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $190.55 / $190.55	Professional		$147.91	$190.55	$190.55