Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $128.82 / $199.53	Facility		$52.48	$128.82	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $57.54 / $85.11	Professional		$44.67	$57.54	$85.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $131.83 / $165.96	Professional		$89.13	$131.83	$165.96
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $123.03 / $208.93	Professional		$69.18	$123.03	$208.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $83.18 / $158.49	Facility		$69.18	$83.18	$158.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $83.18 / $229.09	Professional		$35.48	$83.18	$229.09
Midlands Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $89.13	Professional		$83.18	$83.18	$89.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $74.13 / $144.54	Professional		$69.18	$74.13	$144.54
United Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $158.49	Facility		$69.18	$69.18	$158.49
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $40.74 / $173.78	Professional		$35.48	$40.74	$173.78
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Professional		$69.18	$69.18	$69.18