Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $168.72 / $173.79 / $571.50	Facility		$168.72	$173.79	$571.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.35 / $53.26 / $173.79	Professional		$36.35	$53.26	$173.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.60 / $97.71 / $132.04	Professional		$51.60	$97.71	$132.04
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $35.79 / $67.08 / $189.81	Professional		$35.79	$67.08	$189.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $46.95 / $89.69 / $136.16	Facility		$46.95	$89.69	$136.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $67.87 / $111.77 / $477.31	Professional		$67.87	$111.77	$477.31
Midlands Facility/Professional Facility Modifier Low / Median / High Price $80.28 / $98.30 / $123.54	Facility		$80.28	$98.30	$123.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $73.12 / $98.30 / $126.11	Professional		$73.12	$98.30	$126.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $37.06 / $65.23 / $91.11	Professional		$37.06	$65.23	$91.11
United Facility/Professional Professional Modifier Low / Median / High Price $55.61 / $98.56 / $131.54	Professional		$55.61	$98.56	$131.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $75.37 / $90.30 / $112.30	Professional		$75.37	$90.30	$112.30