Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.42 / $200.63 / $355.67	Facility		$117.42	$200.63	$355.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.65 / $84.03 / $425.29	Professional		$66.65	$84.03	$425.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $167.20 / $167.20 / $167.20	Facility		$167.20	$167.20	$167.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.65 / $145.86 / $206.46	Professional		$68.65	$145.86	$206.46
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $59.44 / $101.07 / $217.96	Professional		$59.44	$101.07	$217.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $70.20 / $129.43 / $196.08	Facility		$70.20	$129.43	$196.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $79.77 / $143.22 / $484.81	Professional		$79.77	$143.22	$484.81
Midlands Facility/Professional Facility Modifier Low / Median / High Price $120.75 / $162.10 / $196.08	Facility		$120.75	$162.10	$196.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $100.18 / $151.54 / $196.08	Professional		$100.18	$151.54	$196.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $62.16 / $110.96 / $139.28	Professional		$62.16	$110.96	$139.28
United Facility/Professional Professional Modifier Low / Median / High Price $76.15 / $102.09 / $168.97	Professional		$76.15	$102.09	$168.97
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $103.10 / $130.50 / $153.50	Professional		$103.10	$130.50	$153.50