Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.74 / $88.74 / $189.50	Facility		$88.74	$88.74	$189.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.26 / $87.64 / $124.82	Professional		$79.26	$87.64	$124.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $257.25 / $264.97 / $272.69	Facility		$257.25	$264.97	$272.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.87 / $219.36 / $281.19	Professional		$77.87	$219.36	$281.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $82.67 / $123.62 / $238.29	Professional		$82.67	$123.62	$238.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $88.74 / $185.39 / $658.72	Facility		$88.74	$185.39	$658.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.71 / $134.00 / $640.03	Professional		$85.71	$134.00	$640.03
Midlands Facility/Professional Facility Modifier Low / Median / High Price $134.00 / $203.52 / $323.79	Facility		$134.00	$203.52	$323.79
Midlands Facility/Professional Professional Modifier Low / Median / High Price $112.00 / $189.59 / $243.80	Professional		$112.00	$189.59	$243.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $128.40 / $128.40 / $236.40	Professional		$128.40	$128.40	$236.40
United Facility/Professional Professional Modifier Low / Median / High Price $83.53 / $108.26 / $172.45	Professional		$83.53	$108.26	$172.45
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $129.01 / $163.30 / $192.10	Professional		$129.01	$163.30	$192.10