Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $249.90 / $249.90 / $476.83	Facility		$249.90	$249.90	$476.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $216.90 / $216.90 / $249.90	Professional		$216.90	$216.90	$249.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $216.00 / $235.32 / $309.62	Professional		$216.00	$235.32	$309.62
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $216.90 / $392.59 / $605.36	Professional		$216.90	$392.59	$605.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $216.74 / $249.90 / $377.29	Facility		$216.74	$249.90	$377.29
Medica Facility/Professional Professional Modifier Low / Median / High Price $216.74 / $241.28 / $936.51	Professional		$216.74	$241.28	$936.51
Midlands Facility/Professional Facility Modifier Low / Median / High Price $254.39 / $325.11 / $397.10	Facility		$254.39	$325.11	$397.10
Midlands Facility/Professional Professional Modifier Low / Median / High Price $252.66 / $275.75 / $326.66	Professional		$252.66	$275.75	$326.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $221.22 / $429.82 / $453.09	Professional		$221.22	$429.82	$453.09
United Facility/Professional Professional Modifier Low / Median / High Price $216.90 / $223.41 / $258.11	Professional		$216.90	$223.41	$258.11
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $237.19 / $237.19 / $237.19	Facility		$237.19	$237.19	$237.19
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $187.38 / $237.19 / $237.19	Professional		$187.38	$237.19	$237.19