Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.77 / $51.77 / $51.77	Facility		$51.77	$51.77	$51.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.87 / $30.37 / $60.57	Professional		$26.87	$30.37	$60.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.13 / $88.71 / $91.30	Facility		$86.13	$88.71	$91.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.21 / $72.92 / $91.14	Professional		$31.21	$72.92	$91.14
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $27.33 / $42.74 / $79.11	Professional		$27.33	$42.74	$79.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.32 / $63.54 / $289.80	Facility		$38.32	$63.54	$289.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.01 / $45.94 / $204.50	Professional		$28.01	$45.94	$204.50
Midlands Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $66.90 / $106.44	Facility		$50.00	$66.90	$106.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $46.00 / $61.48 / $93.64	Professional		$46.00	$61.48	$93.64
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.00 / $42.00 / $79.30	Professional		$42.00	$42.00	$79.30
United Facility/Professional Facility Modifier Low / Median / High Price $147.11 / $151.31 / $217.94	Facility		$147.11	$151.31	$217.94
United Facility/Professional Professional Modifier Low / Median / High Price $28.01 / $33.61 / $58.94	Professional		$28.01	$33.61	$58.94
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $42.42 / $53.70 / $63.10	Professional		$42.42	$53.70	$63.10