Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $8.32 / $25.26 / $201.64	Facility		$8.32	$25.26	$201.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.44 / $153.37 / $248.64	Professional		$105.44	$153.37	$248.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $142.00 / $142.00 / $300.07	Facility		$142.00	$142.00	$300.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $142.00 / $301.00 / $397.50	Professional		$142.00	$301.00	$397.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $260.48 / $275.68 / $336.40	Professional		$260.48	$275.68	$336.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $179.40 / $322.08 / $1,281.52	Facility		$179.40	$322.08	$1,281.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $122.20 / $140.63 / $372.73	Professional		$122.20	$140.63	$372.73
Midlands Facility/Professional Facility Modifier Low / Median / High Price $300.07 / $300.07 / $372.11	Facility		$300.07	$300.07	$372.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $299.20 / $354.63 / $573.45	Professional		$299.20	$354.63	$573.45
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $274.19 / $293.66 / $496.68	Professional		$274.19	$293.66	$496.68
United Facility/Professional Professional Modifier Low / Median / High Price $124.61 / $136.10 / $324.77	Professional		$124.61	$136.10	$324.77
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $259.14 / $259.14 / $259.14	Facility		$259.14	$259.14	$259.14
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $204.73 / $259.14 / $259.14	Professional		$204.73	$259.14	$259.14