Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $282.63 / $282.63 / $2,063.88	Facility		$282.63	$282.63	$2,063.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.74 / $138.74 / $282.63	Professional		$138.74	$138.74	$282.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.94 / $163.63 / $192.29	Professional		$138.94	$163.63	$192.29
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $138.74 / $138.74 / $251.12	Professional		$138.74	$138.74	$251.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $136.18 / $229.73 / $341.66	Facility		$136.18	$229.73	$341.66
Medica Facility/Professional Professional Modifier Low / Median / High Price $136.18 / $136.18 / $282.00	Professional		$136.18	$136.18	$282.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $158.18 / $163.63 / $208.13	Facility		$158.18	$163.63	$208.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $159.75 / $166.09 / $208.13	Professional		$159.75	$166.09	$208.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $228.80 / $248.00 / $301.60	Professional		$228.80	$248.00	$301.60
United Facility/Professional Professional Modifier Low / Median / High Price $138.74 / $138.74 / $152.61	Professional		$138.74	$138.74	$152.61
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $136.18 / $136.18 / $136.18	Facility		$136.18	$136.18	$136.18
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $107.58 / $136.18 / $136.18	Professional		$107.58	$136.18	$136.18