Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.06 / $113.79 / $159.16	Facility		$63.06	$113.79	$159.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.60 / $50.89 / $56.74	Professional		$38.60	$50.89	$56.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.23 / $106.41 / $133.01	Professional		$70.23	$106.41	$133.01
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $71.20 / $102.36 / $140.16	Professional		$71.20	$102.36	$140.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $58.49 / $75.48 / $149.11	Facility		$58.49	$75.48	$149.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.09 / $58.49 / $188.75	Professional		$35.09	$58.49	$188.75
Midlands Facility/Professional Facility Modifier Low / Median / High Price $70.19 / $107.25 / $129.99	Facility		$70.19	$107.25	$129.99
Midlands Facility/Professional Professional Modifier Low / Median / High Price $70.19 / $107.25 / $128.18	Professional		$70.19	$107.25	$128.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $58.49 / $58.49 / $104.40	Professional		$58.49	$58.49	$104.40
United Facility/Professional Facility Modifier Low / Median / High Price $58.49 / $58.49 / $58.49	Facility		$58.49	$58.49	$58.49
United Facility/Professional Professional Modifier Low / Median / High Price $35.09 / $35.09 / $147.91	Professional		$35.09	$35.09	$147.91
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $58.49 / $58.49 / $58.49	Professional		$58.49	$58.49	$58.49