Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $363.08 / $380.19	Facility		$70.79	$363.08	$380.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $79.43 / $257.04	Professional		$51.29	$79.43	$257.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $112.20 / $117.49	Facility		$109.65	$112.20	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $190.55 / $239.88	Professional		$158.49	$190.55	$239.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $128.82 / $416.87	Professional		$77.62	$128.82	$416.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $109.65 / $204.17	Facility		$70.79	$109.65	$204.17
Medica Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $117.49 / $380.19	Professional		$57.54	$117.49	$380.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $165.96 / $281.84	Professional		$107.15	$165.96	$281.84
Midlands Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $117.49	Facility		$117.49	$117.49	$117.49
Midlands Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $204.17 / $213.80	Professional		$66.07	$204.17	$213.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $81.28 / $213.80	Professional		$66.07	$81.28	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $83.18 / $154.88	Professional		$54.95	$83.18	$154.88
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $165.96	Professional		$141.25	$141.25	$165.96