Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $182.18 / $182.18 / $184.00	Professional		$182.18	$182.18	$184.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.85 / $217.21 / $236.84	Professional		$125.85	$217.21	$236.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $154.85 / $214.80 / $367.20	Professional		$154.85	$214.80	$367.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $182.18 / $280.56 / $523.00	Facility		$182.18	$280.56	$523.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $182.18 / $182.18 / $364.36	Professional		$182.18	$182.18	$364.36
Midlands Facility/Professional Facility Modifier Low / Median / High Price $128.34 / $218.62 / $273.27	Facility		$128.34	$218.62	$273.27
Midlands Facility/Professional Professional Modifier Low / Median / High Price $125.85 / $218.62 / $273.27	Professional		$125.85	$218.62	$273.27
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $278.60 / $278.60 / $338.80	Professional		$278.60	$278.60	$338.80
United Facility/Professional Professional Modifier Low / Median / High Price $182.18 / $182.18 / $200.40	Professional		$182.18	$182.18	$200.40
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $182.18 / $182.18 / $182.18	Facility		$182.18	$182.18	$182.18
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $143.91 / $182.18 / $182.18	Professional		$143.91	$182.18	$182.18