Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $74.13 / $354.81	Facility		$53.70	$74.13	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $81.28 / $354.81	Professional		$51.29	$81.28	$354.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $218.78 / $223.87	Facility		$208.93	$218.78	$223.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $141.25 / $177.83	Professional		$75.86	$141.25	$177.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $138.04 / $288.40	Professional		$56.23	$138.04	$288.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $131.83 / $512.86	Facility		$54.95	$131.83	$512.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $112.20 / $478.63	Professional		$64.57	$112.20	$478.63
Midlands Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $141.25 / $186.21	Professional		$120.23	$141.25	$186.21
Midlands Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Facility		$223.87	$223.87	$223.87
Midlands Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $141.25 / $165.96	Professional		$131.83	$141.25	$165.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $42.66 / $100.00	Professional		$20.89	$42.66	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $77.62 / $138.04	Professional		$63.10	$77.62	$138.04
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $107.15 / $125.89	Professional		$107.15	$107.15	$125.89