Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $117.49 / $363.08	Facility		$40.74	$117.49	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $79.43 / $181.97	Professional		$28.84	$79.43	$181.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Facility		$199.53	$199.53	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $77.62 / $213.80	Professional		$31.62	$77.62	$213.80
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $131.83 / $269.15	Professional		$28.84	$131.83	$269.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $107.15 / $199.53	Facility		$35.48	$107.15	$199.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $154.88 / $588.84	Professional		$74.13	$154.88	$588.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $165.96 / $218.78	Professional		$66.07	$165.96	$218.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $158.49 / $229.09	Professional		$57.54	$158.49	$229.09
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $77.62 / $181.97	Professional		$24.55	$77.62	$181.97
United Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $186.21 / $234.42	Facility		$104.71	$186.21	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $75.86 / $169.82	Professional		$30.90	$75.86	$169.82
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $66.07 / $181.97	Professional		$53.70	$66.07	$181.97