Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $206.33 / $206.33 / $324.89	Facility		$206.33	$206.33	$324.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.30 / $159.50 / $269.31	Professional		$119.30	$159.50	$269.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $175.00 / $175.00 / $325.08	Facility		$175.00	$175.00	$325.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $175.00 / $344.25 / $430.31	Professional		$175.00	$344.25	$430.31
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $280.75 / $297.54 / $315.06	Professional		$280.75	$297.54	$315.06
Medica Facility/Professional Facility Modifier Low / Median / High Price $185.65 / $350.76 / $1,382.94	Facility		$185.65	$350.76	$1,382.94
Medica Facility/Professional Professional Modifier Low / Median / High Price $131.18 / $152.35 / $403.78	Professional		$131.18	$152.35	$403.78
Midlands Facility/Professional Facility Modifier Low / Median / High Price $324.14 / $325.08 / $403.04	Facility		$324.14	$325.08	$403.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $266.24 / $379.74 / $621.24	Professional		$266.24	$379.74	$621.24
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $296.95 / $318.04 / $538.07	Professional		$296.95	$318.04	$538.07
United Facility/Professional Facility Modifier Low / Median / High Price $424.49 / $424.49 / $689.79	Facility		$424.49	$424.49	$689.79
United Facility/Professional Professional Modifier Low / Median / High Price $131.18 / $147.44 / $347.77	Professional		$131.18	$147.44	$347.77
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $280.75 / $280.75 / $280.75	Facility		$280.75	$280.75	$280.75
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $221.79 / $280.75 / $280.75	Professional		$221.79	$280.75	$280.75