Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $90.23 / $90.23 / $98.36	Facility		$90.23	$90.23	$98.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.93 / $43.99 / $49.04	Professional		$38.93	$43.99	$49.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.94 / $57.82 / $92.71	Professional		$13.94	$57.82	$92.71
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $27.83 / $42.98 / $88.48	Professional		$27.83	$42.98	$88.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $17.70 / $40.03 / $123.75	Facility		$17.70	$40.03	$123.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $17.62 / $52.08 / $252.80	Professional		$17.62	$52.08	$252.80
Midlands Facility/Professional Facility Modifier Low / Median / High Price $18.11 / $65.73 / $104.15	Facility		$18.11	$65.73	$104.15
Midlands Facility/Professional Professional Modifier Low / Median / High Price $18.11 / $65.73 / $104.15	Professional		$18.11	$65.73	$104.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $49.19 / $59.16 / $103.14	Professional		$49.19	$59.16	$103.14
United Facility/Professional Professional Modifier Low / Median / High Price $49.24 / $50.56 / $101.12	Professional		$49.24	$50.56	$101.12
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $50.56 / $50.56 / $50.56	Professional		$50.56	$50.56	$50.56