Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.68 / $95.68 / $95.68	Facility		$95.68	$95.68	$95.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.41 / $77.23 / $108.39	Professional		$70.41	$77.23	$108.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $234.86 / $241.91 / $248.95	Facility		$234.86	$241.91	$248.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.58 / $196.60 / $247.25	Professional		$91.58	$196.60	$247.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $75.58 / $120.58 / $365.36	Professional		$75.58	$120.58	$365.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $79.81 / $160.84 / $264.01	Facility		$79.81	$160.84	$264.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $74.56 / $137.16 / $548.32	Professional		$74.56	$137.16	$548.32
Midlands Facility/Professional Facility Modifier Low / Median / High Price $136.00 / $182.96 / $285.29	Facility		$136.00	$182.96	$285.29
Midlands Facility/Professional Professional Modifier Low / Median / High Price $136.00 / $179.32 / $231.32	Professional		$136.00	$179.32	$231.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $112.10 / $112.10 / $212.90	Professional		$112.10	$112.10	$212.90
United Facility/Professional Professional Modifier Low / Median / High Price $74.56 / $94.19 / $190.86	Professional		$74.56	$94.19	$190.86
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $118.03 / $149.40 / $175.80	Professional		$118.03	$149.40	$175.80