Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.33 / $91.99 / $146.72	Facility		$51.33	$91.99	$146.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.16 / $55.74 / $215.60	Professional		$23.16	$55.74	$215.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.98 / $63.32 / $79.15	Professional		$42.98	$63.32	$79.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $35.09 / $63.51 / $114.86	Professional		$35.09	$63.51	$114.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $35.09 / $68.13 / $122.55	Facility		$35.09	$68.13	$122.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.09 / $49.04 / $185.79	Professional		$35.09	$49.04	$185.79
Midlands Facility/Professional Facility Modifier Low / Median / High Price $42.11 / $71.48 / $110.01	Facility		$42.11	$71.48	$110.01
Midlands Facility/Professional Professional Modifier Low / Median / High Price $42.14 / $72.29 / $102.92	Professional		$42.14	$72.29	$102.92
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $34.14 / $35.09 / $62.64	Professional		$34.14	$35.09	$62.64
United Facility/Professional Facility Modifier Low / Median / High Price $35.09 / $35.09 / $35.09	Facility		$35.09	$35.09	$35.09
United Facility/Professional Professional Modifier Low / Median / High Price $35.09 / $35.09 / $76.81	Professional		$35.09	$35.09	$76.81
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $35.09 / $35.09 / $35.09	Professional		$35.09	$35.09	$35.09