Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.03 / $81.03 / $81.03	Facility		$81.03	$81.03	$81.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.20 / $75.59 / $111.64	Professional		$69.20	$75.59	$111.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $215.85 / $222.33 / $228.80	Facility		$215.85	$222.33	$228.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.61 / $177.98 / $245.32	Professional		$64.61	$177.98	$245.32
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $71.34 / $103.93 / $204.76	Professional		$71.34	$103.93	$204.76
Medica Facility/Professional Facility Modifier Low / Median / High Price $81.03 / $147.47 / $378.47	Facility		$81.03	$147.47	$378.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $67.00 / $116.44 / $572.92	Professional		$67.00	$116.44	$572.92
Midlands Facility/Professional Facility Modifier Low / Median / High Price $94.00 / $177.91 / $283.05	Facility		$94.00	$177.91	$283.05
Midlands Facility/Professional Professional Modifier Low / Median / High Price $83.97 / $160.18 / $218.58	Professional		$83.97	$160.18	$218.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $198.60	Professional		$112.20	$112.20	$198.60
United Facility/Professional Facility Modifier Low / Median / High Price $241.04 / $246.00 / $357.10	Facility		$241.04	$246.00	$357.10
United Facility/Professional Professional Modifier Low / Median / High Price $76.34 / $91.66 / $162.58	Professional		$76.34	$91.66	$162.58
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $112.73 / $142.69 / $167.90	Professional		$112.73	$142.69	$167.90