Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $166.12 / $166.12 / $166.12	Facility		$166.12	$166.12	$166.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.97 / $76.84 / $106.68	Professional		$67.97	$76.84	$106.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $339.30 / $349.48 / $359.66	Facility		$339.30	$349.48	$359.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.42 / $207.11 / $280.50	Professional		$81.42	$207.11	$280.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $102.57 / $173.26 / $311.45	Professional		$102.57	$173.26	$311.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $61.20 / $166.12 / $478.95	Facility		$61.20	$166.12	$478.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $70.94 / $147.06 / $857.73	Professional		$70.94	$147.06	$857.73
Midlands Facility/Professional Facility Modifier Low / Median / High Price $58.12 / $161.28 / $316.61	Facility		$58.12	$161.28	$316.61
Midlands Facility/Professional Professional Modifier Low / Median / High Price $58.12 / $169.58 / $272.00	Professional		$58.12	$169.58	$272.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $27.98 / $50.84 / $192.73	Professional		$27.98	$50.84	$192.73
United Facility/Professional Professional Modifier Low / Median / High Price $75.91 / $106.41 / $314.44	Professional		$75.91	$106.41	$314.44
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $148.84 / $188.40 / $221.70	Professional		$148.84	$188.40	$221.70