Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $87.10 / $213.80	Facility		$46.77	$87.10	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $43.65 / $281.84	Professional		$30.90	$43.65	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $91.20 / $112.20	Professional		$57.54	$91.20	$112.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $67.61 / $213.80	Professional		$45.71	$67.61	$213.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $56.23 / $125.89	Facility		$46.77	$56.23	$125.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $51.29 / $117.49	Professional		$16.22	$51.29	$117.49
Midlands Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $57.54 / $60.26	Professional		$56.23	$57.54	$60.26
Midlands Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $57.54	Facility		$57.54	$57.54	$57.54
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $257.04 / $257.04	Facility		$257.04	$257.04	$257.04
United Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $46.77 / $104.71	Facility		$46.77	$46.77	$104.71
United Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $28.18 / $95.50	Professional		$15.49	$28.18	$95.50
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $46.77 / $46.77	Professional		$37.15	$46.77	$46.77