Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.93 / $91.91 / $128.57	Facility		$50.93	$91.91	$128.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.19 / $41.11 / $45.83	Professional		$31.19	$41.11	$45.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.75 / $85.52 / $106.90	Professional		$56.75	$85.52	$106.90
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $59.06 / $82.69 / $208.82	Professional		$59.06	$82.69	$208.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $47.25 / $60.97 / $126.16	Facility		$47.25	$60.97	$126.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.35 / $47.25 / $152.47	Professional		$28.35	$47.25	$152.47
Midlands Facility/Professional Facility Modifier Low / Median / High Price $56.70 / $86.65 / $105.00	Facility		$56.70	$86.65	$105.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $56.70 / $86.65 / $103.55	Professional		$56.70	$86.65	$103.55
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $47.25 / $47.25 / $84.34	Professional		$47.25	$47.25	$84.34
United Facility/Professional Facility Modifier Low / Median / High Price $47.25 / $47.25 / $47.25	Facility		$47.25	$47.25	$47.25
United Facility/Professional Professional Modifier Low / Median / High Price $28.35 / $28.35 / $103.01	Professional		$28.35	$28.35	$103.01
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $47.25 / $47.25 / $47.25	Professional		$47.25	$47.25	$47.25