Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.75 / $105.94 / $262.30	Facility		$43.75	$105.94	$262.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.66 / $51.41 / $78.03	Professional		$15.66	$51.41	$78.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.90 / $74.45 / $178.02	Professional		$22.90	$74.45	$178.02
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $100.82 / $181.37	Professional		$18.62	$100.82	$181.37
Medica Facility/Professional Facility Modifier Low / Median / High Price $23.03 / $75.27 / $131.87	Facility		$23.03	$75.27	$131.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $115.39 / $406.69	Professional		$68.20	$115.39	$406.69
Midlands Facility/Professional Facility Modifier Low / Median / High Price $25.59 / $88.88 / $178.02	Facility		$25.59	$88.88	$178.02
Midlands Facility/Professional Professional Modifier Low / Median / High Price $25.59 / $88.88 / $178.02	Professional		$25.59	$88.88	$178.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $103.80 / $103.80 / $173.20	Professional		$103.80	$103.80	$173.20
United Facility/Professional Professional Modifier Low / Median / High Price $69.15 / $103.41 / $170.98	Professional		$69.15	$103.41	$170.98
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $33.40 / $40.90 / $172.10	Professional		$33.40	$40.90	$172.10