Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.00 / $93.83 / $149.13	Facility		$52.00	$93.83	$149.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.84 / $41.97 / $46.79	Professional		$31.84	$41.97	$46.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.89 / $87.48 / $109.34	Professional		$57.89	$87.48	$109.34
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $48.24 / $85.82 / $111.04	Professional		$48.24	$85.82	$111.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $48.24 / $62.71 / $126.98	Facility		$48.24	$62.71	$126.98
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.94 / $49.69 / $185.79	Professional		$28.94	$49.69	$185.79
Midlands Facility/Professional Facility Modifier Low / Median / High Price $57.89 / $88.45 / $126.98	Facility		$57.89	$88.45	$126.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $57.89 / $84.54 / $125.91	Professional		$57.89	$84.54	$125.91
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $46.94 / $48.24 / $86.11	Professional		$46.94	$48.24	$86.11
United Facility/Professional Professional Modifier Low / Median / High Price $28.94 / $28.94 / $98.01	Professional		$28.94	$28.94	$98.01
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $48.24 / $48.24 / $48.24	Professional		$48.24	$48.24	$48.24