Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $156.12 / $193.50 / $386.00	Professional		$156.12	$193.50	$386.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $247.20 / $267.75 / $334.69	Professional		$247.20	$267.75	$334.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $220.54 / $244.63 / $418.15	Professional		$220.54	$244.63	$418.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $176.96 / $263.22 / $386.67	Facility		$176.96	$263.22	$386.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $111.16 / $141.74 / $573.55	Professional		$111.16	$141.74	$573.55
Midlands Facility/Professional Facility Modifier Low / Median / High Price $230.10 / $254.12 / $332.51	Facility		$230.10	$254.12	$332.51
Midlands Facility/Professional Professional Modifier Low / Median / High Price $220.06 / $264.08 / $386.57	Professional		$220.06	$264.08	$386.57
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $219.47 / $286.00 / $420.62	Professional		$219.47	$286.00	$420.62
United Facility/Professional Professional Modifier Low / Median / High Price $108.49 / $115.25 / $197.85	Professional		$108.49	$115.25	$197.85
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $207.92 / $207.92 / $207.92	Facility		$207.92	$207.92	$207.92
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $164.26 / $207.92 / $207.92	Professional		$164.26	$207.92	$207.92