Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.73 / $216.74 / $244.91	Facility		$106.73	$216.74	$244.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $142.66 / $195.32 / $298.92	Professional		$142.66	$195.32	$298.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $214.16 / $214.16 / $343.13	Facility		$214.16	$214.16	$343.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $214.16 / $342.45 / $451.88	Professional		$214.16	$342.45	$451.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $304.30 / $311.94 / $348.84	Professional		$304.30	$311.94	$348.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $195.96 / $368.46 / $1,620.96	Facility		$195.96	$368.46	$1,620.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $149.13 / $172.77 / $426.20	Professional		$149.13	$172.77	$426.20
Midlands Facility/Professional Facility Modifier Low / Median / High Price $343.13 / $343.13 / $473.89	Facility		$343.13	$343.13	$473.89
Midlands Facility/Professional Professional Modifier Low / Median / High Price $342.13 / $411.25 / $655.73	Professional		$342.13	$411.25	$655.73
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,029.38 / $1,029.38 / $1,029.38	Facility		$1,029.38	$1,029.38	$1,029.38
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $311.94 / $334.09 / $567.95	Professional		$311.94	$334.09	$567.95
United Facility/Professional Facility Modifier Low / Median / High Price $128.53 / $154.24 / $185.12	Facility		$128.53	$154.24	$185.12
United Facility/Professional Professional Modifier Low / Median / High Price $149.13 / $158.35 / $405.52	Professional		$149.13	$158.35	$405.52
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $296.33 / $296.33 / $296.33	Facility		$296.33	$296.33	$296.33
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $234.11 / $296.33 / $296.33	Professional		$234.11	$296.33	$296.33