Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.95 / $133.44 / $291.50	Facility		$73.95	$133.44	$291.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.28 / $59.68 / $66.54	Professional		$45.28	$59.68	$66.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.02 / $124.68 / $155.86	Professional		$84.02	$124.68	$155.86
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $68.59 / $124.17 / $251.10	Professional		$68.59	$124.17	$251.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $68.59 / $106.18 / $215.06	Facility		$68.59	$106.18	$215.06
Medica Facility/Professional Professional Modifier Low / Median / High Price $68.59 / $102.90 / $296.79	Professional		$68.59	$102.90	$296.79
Midlands Facility/Professional Facility Modifier Low / Median / High Price $88.52 / $139.77 / $215.06	Facility		$88.52	$139.77	$215.06
Midlands Facility/Professional Professional Modifier Low / Median / High Price $88.52 / $139.77 / $196.54	Professional		$88.52	$139.77	$196.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $66.75 / $68.59 / $122.45	Professional		$66.75	$68.59	$122.45
United Facility/Professional Professional Modifier Low / Median / High Price $68.59 / $68.59 / $166.16	Professional		$68.59	$68.59	$166.16
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $68.59 / $68.59 / $68.59	Professional		$68.59	$68.59	$68.59