Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.89 / $73.83 / $104.02	Facility		$63.89	$73.83	$104.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.47 / $62.34 / $271.12	Professional		$53.47	$62.34	$271.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $210.59 / $216.91 / $223.23	Facility		$210.59	$216.91	$223.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.73 / $138.85 / $187.91	Professional		$78.73	$138.85	$187.91
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $54.12 / $99.12 / $283.99	Professional		$54.12	$99.12	$283.99
Medica Facility/Professional Facility Modifier Low / Median / High Price $55.34 / $130.55 / $257.74	Facility		$55.34	$130.55	$257.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $66.04 / $113.00 / $480.87	Professional		$66.04	$113.00	$480.87
Midlands Facility/Professional Facility Modifier Low / Median / High Price $114.74 / $138.00 / $223.23	Facility		$114.74	$138.00	$223.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $113.00 / $132.78 / $187.91	Professional		$113.00	$132.78	$187.91
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $19.36 / $40.93 / $101.60	Professional		$19.36	$40.93	$101.60
United Facility/Professional Professional Modifier Low / Median / High Price $63.56 / $78.81 / $139.10	Professional		$63.56	$78.81	$139.10
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $83.82 / $106.10 / $124.90	Professional		$83.82	$106.10	$124.90