Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $149.44 / $206.02 / $221.26	Professional		$149.44	$206.02	$221.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.60 / $336.75 / $420.94	Professional		$104.60	$336.75	$420.94
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $171.61 / $246.98 / $290.57	Professional		$171.61	$246.98	$290.57
Medica Facility/Professional Facility Modifier Low / Median / High Price $181.57 / $258.47 / $504.02	Facility		$181.57	$258.47	$504.02
Medica Facility/Professional Professional Modifier Low / Median / High Price $108.72 / $128.94 / $226.00	Professional		$108.72	$128.94	$226.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $226.00 / $284.32 / $504.02	Facility		$226.00	$284.32	$504.02
Midlands Facility/Professional Professional Modifier Low / Median / High Price $226.00 / $257.41 / $504.02	Professional		$226.00	$257.41	$504.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $258.47 / $296.38 / $529.04	Professional		$258.47	$296.38	$529.04
United Facility/Professional Professional Modifier Low / Median / High Price $90.60 / $128.94 / $165.10	Professional		$90.60	$128.94	$165.10
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $183.77 / $232.62 / $232.62	Professional		$183.77	$232.62	$232.62