Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.59 / $134.91 / $205.71	Facility		$75.59	$134.91	$205.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.21 / $58.21 / $73.33	Professional		$58.21	$58.21	$73.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.14 / $137.74 / $172.18	Professional		$87.14	$137.74	$172.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $64.26 / $111.14 / $132.30	Professional		$64.26	$111.14	$132.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.60 / $90.72 / $173.88	Facility		$29.60	$90.72	$173.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $17.96 / $59.52 / $173.88	Professional		$17.96	$59.52	$173.88
Midlands Facility/Professional Facility Modifier Low / Median / High Price $26.94 / $98.28 / $165.68	Facility		$26.94	$98.28	$165.68
Midlands Facility/Professional Professional Modifier Low / Median / High Price $52.98 / $98.69 / $165.68	Professional		$52.98	$98.69	$165.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $75.59 / $75.59 / $134.94	Professional		$75.59	$75.59	$134.94
United Facility/Professional Professional Modifier Low / Median / High Price $17.96 / $45.36 / $96.59	Professional		$17.96	$45.36	$96.59
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $59.72 / $75.59 / $75.59	Professional		$59.72	$75.59	$75.59