Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.00 / $153.69 / $214.97	Facility		$79.00	$153.69	$214.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.51 / $213.51 / $213.51	Professional		$213.51	$213.51	$213.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $216.50 / $223.00 / $229.49	Facility		$216.50	$223.00	$229.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.50 / $101.94 / $150.40	Professional		$82.50	$101.94	$150.40
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $86.90 / $118.50 / $142.99	Professional		$86.90	$118.50	$142.99
Medica Facility/Professional Facility Modifier Low / Median / High Price $75.05 / $102.70 / $223.00	Facility		$75.05	$102.70	$223.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $47.40 / $79.00 / $310.80	Professional		$47.40	$79.00	$310.80
Midlands Facility/Professional Facility Modifier Low / Median / High Price $94.80 / $150.40 / $223.00	Facility		$94.80	$150.40	$223.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $94.80 / $153.34 / $201.45	Professional		$94.80	$153.34	$201.45
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $76.87 / $79.00 / $141.01	Professional		$76.87	$79.00	$141.01
United Facility/Professional Professional Modifier Low / Median / High Price $47.40 / $47.40 / $199.79	Professional		$47.40	$47.40	$199.79
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $79.00 / $79.00	Professional		$79.00	$79.00	$79.00