Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.41 / $127.34 / $363.21	Facility		$66.41	$127.34	$363.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.27 / $71.86 / $175.30	Professional		$27.27	$71.86	$175.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $199.20 / $199.20 / $199.20	Facility		$199.20	$199.20	$199.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.74 / $81.87 / $214.98	Professional		$31.74	$81.87	$214.98
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $27.74 / $107.66 / $266.66	Professional		$27.74	$107.66	$266.66
Medica Facility/Professional Facility Modifier Low / Median / High Price $41.48 / $112.63 / $202.01	Facility		$41.48	$112.63	$202.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $79.11 / $167.96 / $586.42	Professional		$79.11	$167.96	$586.42
Midlands Facility/Professional Facility Modifier Low / Median / High Price $60.52 / $155.69 / $210.76	Facility		$60.52	$155.69	$210.76
Midlands Facility/Professional Professional Modifier Low / Median / High Price $57.95 / $155.69 / $210.76	Professional		$57.95	$155.69	$210.76
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $26.42 / $74.51 / $153.96	Professional		$26.42	$74.51	$153.96
United Facility/Professional Professional Modifier Low / Median / High Price $82.06 / $125.15 / $190.22	Professional		$82.06	$125.15	$190.22
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $54.20 / $66.30 / $182.50	Professional		$54.20	$66.30	$182.50