Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $112.20	Facility		$89.13	$89.13	$112.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $67.61 / $269.15	Professional		$44.67	$67.61	$269.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $120.23 / $213.80	Professional		$61.66	$120.23	$213.80
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $141.25 / $288.40	Professional		$79.43	$141.25	$288.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $131.83 / $331.13	Facility		$69.18	$131.83	$331.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $131.83 / $954.99	Professional		$63.10	$131.83	$954.99
Midlands Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $131.83 / $186.21	Professional		$70.79	$131.83	$186.21
Midlands Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $125.89 / $147.91	Professional		$120.23	$125.89	$147.91
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $102.33 / $128.82	Professional		$57.54	$102.33	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $66.07 / $245.47	Professional		$63.10	$66.07	$245.47
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $125.89 / $125.89	Professional		$107.15	$125.89	$125.89