Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $309.03	Facility		$67.61	$67.61	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $52.48 / $165.96	Professional		$44.67	$52.48	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $109.65 / $128.82	Professional		$70.79	$109.65	$128.82
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $74.13 / $281.84	Professional		$50.12	$74.13	$281.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $97.72 / $204.17	Facility		$50.12	$97.72	$204.17
Medica Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $114.82 / $309.03	Professional		$66.07	$114.82	$309.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $123.03 / $131.83	Professional		$97.72	$123.03	$131.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $128.82 / $199.53	Professional		$117.49	$128.82	$199.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $79.43 / $112.20	Professional		$43.65	$79.43	$112.20
United Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $239.88 / $309.03	Facility		$138.04	$239.88	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $85.11 / $134.90	Professional		$53.70	$85.11	$134.90
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $117.49	Professional		$97.72	$97.72	$117.49