Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $70.79 / $70.79	Facility		$70.79	$70.79	$70.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $44.67 / $109.65	Professional		$40.74	$44.67	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $112.20 / $125.89	Professional		$102.33	$112.20	$125.89
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $85.11 / $1,819.70	Professional		$44.67	$85.11	$1,819.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $549.54 / $1,621.81	Facility		$83.18	$549.54	$1,621.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $95.50 / $630.96	Professional		$53.70	$95.50	$630.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $112.20 / $169.82	Professional		$95.50	$112.20	$169.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $117.49 / $117.49	Professional		$85.11	$117.49	$117.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $93.33 / $109.65	Professional		$85.11	$93.33	$109.65
United Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $1,380.38 / $2,344.23	Facility		$812.83	$1,380.38	$2,344.23
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $75.86 / $144.54	Professional		$48.98	$75.86	$144.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $97.72	Professional		$83.18	$83.18	$97.72