Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $241.87 / $365.08 / $365.08	Facility		$241.87	$365.08	$365.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.30 / $245.30 / $272.52	Professional		$245.30	$245.30	$272.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.66 / $296.42 / $319.61	Professional		$251.66	$296.42	$319.61
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $186.54 / $245.30 / $443.99	Professional		$186.54	$245.30	$443.99
Medica Facility/Professional Facility Modifier Low / Median / High Price $241.87 / $323.08 / $399.09	Facility		$241.87	$323.08	$399.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $241.87 / $241.87 / $483.74	Professional		$241.87	$241.87	$483.74
Midlands Facility/Professional Facility Modifier Low / Median / High Price $276.70 / $296.42 / $364.09	Facility		$276.70	$296.42	$364.09
Midlands Facility/Professional Professional Modifier Low / Median / High Price $290.24 / $296.42 / $364.09	Professional		$290.24	$296.42	$364.09
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $413.90 / $413.90 / $503.40	Professional		$413.90	$413.90	$503.40
United Facility/Professional Professional Modifier Low / Median / High Price $245.30 / $245.30 / $270.49	Professional		$245.30	$245.30	$270.49
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $241.87 / $241.87 / $241.87	Facility		$241.87	$241.87	$241.87
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $191.08 / $241.87 / $241.87	Professional		$191.08	$241.87	$241.87