Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $117.49 / $269.15	Professional		$60.26	$117.49	$269.15
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $109.65 / $134.90 / $295.12	Professional	25	$109.65	$134.90	$295.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $112.20 / $245.47	Professional		$61.66	$112.20	$245.47
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $91.20 / $281.84	Professional		$54.95	$91.20	$281.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $169.82 / $302.00	Facility		$69.18	$169.82	$302.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $169.82 / $478.63	Professional		$114.82	$169.82	$478.63
Midlands Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $218.78 / $331.13	Professional		$165.96	$218.78	$331.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Professional		$245.47	$245.47	$245.47
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $128.82 / $263.03	Professional		$64.57	$128.82	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $114.82 / $190.55	Professional		$72.44	$114.82	$190.55
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $162.18 / $269.15	Professional		$138.04	$162.18	$269.15