Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.64 / $104.02 / $148.54	Facility		$57.64	$104.02	$148.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.17 / $46.49 / $51.87	Professional		$41.17	$46.49	$51.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.16 / $97.27 / $121.58	Professional		$64.16	$97.27	$121.58
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $53.47 / $86.96 / $100.11	Professional		$53.47	$86.96	$100.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $53.47 / $69.00 / $129.01	Facility		$53.47	$69.00	$129.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.62 / $55.07 / $185.08	Professional		$30.62	$55.07	$185.08
Midlands Facility/Professional Facility Modifier Low / Median / High Price $64.16 / $89.00 / $124.48	Facility		$64.16	$89.00	$124.48
Midlands Facility/Professional Professional Modifier Low / Median / High Price $59.94 / $86.62 / $124.48	Professional		$59.94	$86.62	$124.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $52.03 / $62.56 / $109.08	Professional		$52.03	$62.56	$109.08
United Facility/Professional Facility Modifier Low / Median / High Price $53.47 / $53.47 / $53.47	Facility		$53.47	$53.47	$53.47
United Facility/Professional Professional Modifier Low / Median / High Price $30.62 / $32.08 / $116.56	Professional		$30.62	$32.08	$116.56
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $53.47 / $53.47 / $53.47	Professional		$53.47	$53.47	$53.47