Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.87 / $121.02 / $619.15	Facility		$58.87	$121.02	$619.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.42 / $44.54 / $594.88	Professional		$39.42	$44.54	$594.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.48 / $92.70 / $115.87	Professional		$61.48	$92.70	$115.87
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $51.19 / $92.65 / $179.35	Professional		$51.19	$92.65	$179.35
Medica Facility/Professional Facility Modifier Low / Median / High Price $51.19 / $68.48 / $136.68	Facility		$51.19	$68.48	$136.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $51.19 / $63.55 / $212.64	Professional		$51.19	$63.55	$212.64
Midlands Facility/Professional Facility Modifier Low / Median / High Price $66.06 / $93.87 / $148.72	Facility		$66.06	$93.87	$148.72
Midlands Facility/Professional Professional Modifier Low / Median / High Price $61.48 / $93.87 / $133.61	Professional		$61.48	$93.87	$133.61
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $189.48 / $189.48 / $189.48	Facility		$189.48	$189.48	$189.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $49.81 / $51.19 / $91.37	Professional		$49.81	$51.19	$91.37
United Facility/Professional Professional Modifier Low / Median / High Price $51.19 / $51.19 / $111.59	Professional		$51.19	$51.19	$111.59
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $51.19 / $51.19 / $51.19	Professional		$51.19	$51.19	$51.19