Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $77.62 / $173.78	Professional		$38.90	$77.62	$173.78
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $75.86 / $173.78 / $190.55	Professional	25	$75.86	$173.78	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $77.62 / $162.18	Professional		$42.66	$77.62	$162.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $61.66 / $173.78	Professional		$33.11	$61.66	$173.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $107.15 / $199.53	Facility		$42.66	$107.15	$199.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $112.20 / $309.03	Professional		$77.62	$112.20	$309.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $162.18 / $223.87	Professional		$107.15	$162.18	$223.87
Midlands Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Professional		$162.18	$162.18	$162.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $83.18 / $173.78	Professional		$38.90	$83.18	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $75.86 / $123.03	Professional		$43.65	$75.86	$123.03
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $97.72 / $181.97	Professional		$83.18	$97.72	$181.97