Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.95 / $124.43 / $174.05	Facility		$68.95	$124.43	$174.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.25 / $55.65 / $87.83	Professional		$49.25	$55.65	$87.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.81 / $116.20 / $145.25	Professional		$76.81	$116.20	$145.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $79.86 / $111.93 / $253.87	Professional		$79.86	$111.93	$253.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $63.96 / $82.53 / $147.11	Facility		$63.96	$82.53	$147.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.38 / $63.96 / $206.41	Professional		$38.38	$63.96	$206.41
Midlands Facility/Professional Facility Modifier Low / Median / High Price $76.75 / $117.28 / $142.15	Facility		$76.75	$117.28	$142.15
Midlands Facility/Professional Professional Modifier Low / Median / High Price $76.75 / $117.28 / $149.03	Professional		$76.75	$117.28	$149.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $63.96 / $63.96 / $114.17	Professional		$63.96	$63.96	$114.17
United Facility/Professional Facility Modifier Low / Median / High Price $63.96 / $63.96 / $63.96	Facility		$63.96	$63.96	$63.96
United Facility/Professional Professional Modifier Low / Median / High Price $38.38 / $38.38 / $130.96	Professional		$38.38	$38.38	$130.96
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $63.96 / $63.96 / $63.96	Professional		$63.96	$63.96	$63.96