Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $310.87 / $353.43 / $353.43	Facility		$310.87	$353.43	$353.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.88 / $227.42 / $346.58	Professional		$164.88	$227.42	$346.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $296.00 / $296.00 / $470.79	Facility		$296.00	$296.00	$470.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $296.00 / $489.00 / $611.25	Professional		$296.00	$489.00	$611.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $339.13 / $415.11 / $484.03	Professional		$339.13	$415.11	$484.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $272.94 / $556.39 / $1,976.32	Facility		$272.94	$556.39	$1,976.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $204.61 / $273.39 / $575.25	Professional		$204.61	$273.39	$575.25
Midlands Facility/Professional Facility Modifier Low / Median / High Price $469.42 / $470.79 / $575.25	Facility		$469.42	$470.79	$575.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $385.60 / $549.95 / $899.70	Professional		$385.60	$549.95	$899.70
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,130.54 / $1,130.54 / $1,130.54	Facility		$1,130.54	$1,130.54	$1,130.54
United Facility/Professional Professional Modifier Low / Median / High Price $204.61 / $224.70 / $503.61	Professional		$204.61	$224.70	$503.61
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $419.43 / $419.43 / $419.43	Facility		$419.43	$419.43	$419.43
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $331.35 / $419.43 / $419.43	Professional		$331.35	$419.43	$419.43