Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.66 / $178.32 / $249.43	Facility		$91.66	$178.32	$249.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.50 / $70.58 / $88.91	Professional		$60.50	$70.58	$88.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.99 / $166.46 / $208.08	Professional		$109.99	$166.46	$208.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.83 / $137.49 / $468.48	Professional		$100.83	$137.49	$468.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $91.66 / $119.16 / $217.19	Facility		$91.66	$119.16	$217.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $91.66 / $444.24	Professional		$55.00	$91.66	$444.24
Midlands Facility/Professional Facility Modifier Low / Median / High Price $109.99 / $179.68 / $200.88	Facility		$109.99	$179.68	$200.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $109.99 / $193.90 / $233.73	Professional		$109.99	$193.90	$233.73
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $89.19 / $91.66 / $163.61	Professional		$89.19	$91.66	$163.61
United Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $55.00 / $222.03	Professional		$55.00	$55.00	$222.03
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $91.66 / $91.66 / $91.66	Professional		$91.66	$91.66	$91.66