Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.15 / $64.15 / $64.15	Facility		$64.15	$64.15	$64.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.21 / $53.72 / $78.14	Professional		$46.21	$53.72	$78.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $173.81 / $179.02 / $184.24	Facility		$173.81	$179.02	$184.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.24 / $143.50 / $179.38	Professional		$53.24	$143.50	$179.38
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $53.57 / $79.76 / $164.05	Professional		$53.57	$79.76	$164.05
Medica Facility/Professional Facility Modifier Low / Median / High Price $64.15 / $116.97 / $854.96	Facility		$64.15	$116.97	$854.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.84 / $86.13 / $397.13	Professional		$52.84	$86.13	$397.13
Midlands Facility/Professional Facility Modifier Low / Median / High Price $87.00 / $130.94 / $208.32	Facility		$87.00	$130.94	$208.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $119.63 / $160.35	Professional		$79.00	$119.63	$160.35
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $17.00 / $55.00 / $102.10	Professional		$17.00	$55.00	$102.10
United Facility/Professional Professional Modifier Low / Median / High Price $52.84 / $68.81 / $106.31	Professional		$52.84	$68.81	$106.31
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $83.03 / $105.10 / $123.60	Professional		$83.03	$105.10	$123.60