Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $85.11 / $177.83	Facility		$70.79	$85.11	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $102.33 / $251.19	Professional		$75.86	$102.33	$251.19
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $407.38 / $407.38 / $407.38	Professional	25	$407.38	$407.38	$407.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Facility		$114.82	$114.82	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $104.71 / $234.42	Professional		$63.10	$104.71	$234.42
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $107.15 / $162.18	Professional		$79.43	$107.15	$162.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $104.71 / $162.18	Facility		$89.13	$104.71	$162.18
Medica Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $128.82 / $575.44	Professional		$77.62	$128.82	$575.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $125.89 / $263.03	Professional		$100.00	$125.89	$263.03
Midlands Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Facility		$114.82	$114.82	$114.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $123.03 / $162.18	Professional		$89.13	$123.03	$162.18
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $181.97 / $181.97	Facility		$181.97	$181.97	$181.97
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $112.20 / $199.53	Professional		$79.43	$112.20	$199.53
United Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $70.79 / $70.79	Facility		$70.79	$70.79	$70.79
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $120.23 / $218.78	Professional		$79.43	$120.23	$218.78
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $123.03 / $151.36	Professional		$102.33	$123.03	$151.36