Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $218.78 / $257.04	Facility		$218.78	$218.78	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $190.55 / $309.03	Professional		$147.91	$190.55	$309.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $398.11	Facility		$199.53	$199.53	$398.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $407.38 / $512.86	Professional		$199.53	$407.38	$512.86
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $302.00 / $354.81	Professional		$281.84	$302.00	$354.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $426.58 / $1,659.59	Facility		$239.88	$426.58	$1,659.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $213.80 / $588.84	Professional		$158.49	$213.80	$588.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $407.38 / $478.63	Professional		$389.05	$407.38	$478.63
Midlands Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $398.11 / $398.11	Facility		$398.11	$398.11	$398.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $588.84 / $588.84	Professional		$363.08	$588.84	$588.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $467.74 / $758.58	Professional		$363.08	$467.74	$758.58
United Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $263.03 / $512.86	Facility		$123.03	$263.03	$512.86
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $177.83 / $323.59	Professional		$154.88	$177.83	$323.59
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $346.74 / $346.74	Professional		$275.42	$346.74	$346.74