Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $187.96 / $187.96 / $376.25	Facility		$187.96	$187.96	$376.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.03 / $173.03 / $289.57	Professional		$173.03	$173.03	$289.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $168.04 / $173.03 / $231.59	Professional		$168.04	$173.03	$231.59
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $132.61 / $173.03 / $337.12	Professional		$132.61	$173.03	$337.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $145.22 / $187.96 / $291.61	Facility		$145.22	$187.96	$291.61
Medica Facility/Professional Professional Modifier Low / Median / High Price $172.55 / $191.87 / $2,975.90	Professional		$172.55	$191.87	$2,975.90
Midlands Facility/Professional Facility Modifier Low / Median / High Price $134.30 / $248.57 / $293.79	Facility		$134.30	$248.57	$293.79
Midlands Facility/Professional Professional Modifier Low / Median / High Price $130.88 / $198.53 / $258.82	Professional		$130.88	$198.53	$258.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $173.03 / $342.62 / $361.45	Professional		$173.03	$342.62	$361.45
United Facility/Professional Professional Modifier Low / Median / High Price $173.03 / $178.22 / $207.64	Professional		$173.03	$178.22	$207.64
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $188.83 / $188.83 / $188.83	Facility		$188.83	$188.83	$188.83
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $149.18 / $188.83 / $188.83	Professional		$149.18	$188.83	$188.83