Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $96.90 / $96.90 / $96.90	Facility		$96.90	$96.90	$96.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.43 / $95.58 / $135.25	Professional		$72.43	$95.58	$135.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $138.19 / $138.19 / $138.19	Facility		$138.19	$138.19	$138.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.00 / $130.00 / $249.71	Professional		$66.00	$130.00	$249.71
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $86.66 / $121.24 / $177.52	Professional		$86.66	$121.24	$177.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $95.26 / $117.84 / $168.74	Facility		$95.26	$117.84	$168.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $88.21 / $160.69 / $626.85	Professional		$88.21	$160.69	$626.85
Midlands Facility/Professional Facility Modifier Low / Median / High Price $149.65 / $156.13 / $263.52	Facility		$149.65	$156.13	$263.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $128.88 / $165.98 / $256.10	Professional		$128.88	$165.98	$256.10
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $76.73 / $102.50 / $180.57	Professional		$76.73	$102.50	$180.57
United Facility/Professional Professional Modifier Low / Median / High Price $77.00 / $119.14 / $265.80	Professional		$77.00	$119.14	$265.80
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $110.20 / $113.44 / $143.60	Professional		$110.20	$113.44	$143.60