Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.95 / $116.56 / $179.00	Professional		$68.95	$116.56	$179.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $68.95 / $119.34 / $398.00	Professional	25	$68.95	$119.34	$398.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.17 / $110.71 / $287.30	Professional		$56.17	$110.71	$287.30
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $56.74 / $113.86 / $176.72	Professional		$56.74	$113.86	$176.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $69.26 / $174.08 / $307.88	Facility		$69.26	$174.08	$307.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $115.31 / $166.83 / $476.78	Professional		$115.31	$166.83	$476.78
Midlands Facility/Professional Facility Modifier Low / Median / High Price $156.34 / $186.85 / $287.30	Facility		$156.34	$186.85	$287.30
Midlands Facility/Professional Professional Modifier Low / Median / High Price $150.25 / $194.34 / $309.54	Professional		$150.25	$194.34	$309.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $64.25 / $125.72 / $224.12	Professional		$64.25	$125.72	$224.12
United Facility/Professional Professional Modifier Low / Median / High Price $114.10 / $134.53 / $252.21	Professional		$114.10	$134.53	$252.21
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $137.40 / $161.69 / $271.20	Professional		$137.40	$161.69	$271.20