Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.72 / $197.04 / $197.04	Facility		$169.72	$197.04	$197.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.83 / $133.61 / $191.82	Professional		$93.83	$133.61	$191.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $150.11 / $150.11 / $233.95	Facility		$150.11	$150.11	$233.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $150.11 / $328.88 / $411.09	Professional		$150.11	$328.88	$411.09
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $202.44 / $232.65 / $283.58	Professional		$202.44	$232.65	$283.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $133.61 / $273.29 / $1,107.57	Facility		$133.61	$273.29	$1,107.57
Medica Facility/Professional Professional Modifier Low / Median / High Price $101.68 / $119.87 / $290.58	Professional		$101.68	$119.87	$290.58
Midlands Facility/Professional Facility Modifier Low / Median / High Price $233.27 / $233.95 / $323.08	Facility		$233.27	$233.95	$323.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $198.86 / $276.48 / $447.09	Professional		$198.86	$276.48	$447.09
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $212.68 / $289.25 / $516.30	Professional		$212.68	$289.25	$516.30
United Facility/Professional Professional Modifier Low / Median / High Price $101.68 / $109.64 / $250.32	Professional		$101.68	$109.64	$250.32
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $202.05 / $202.05 / $202.05	Facility		$202.05	$202.05	$202.05
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $159.62 / $202.05 / $202.05	Professional		$159.62	$202.05	$202.05