Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $72.44 / $147.91	Facility		$52.48	$72.44	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $85.11 / $245.47	Professional		$60.26	$85.11	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $144.54 / $181.97	Professional		$85.11	$144.54	$181.97
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $125.89 / $288.40	Professional		$74.13	$125.89	$288.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $117.49 / $162.18	Facility		$72.44	$117.49	$162.18
Medica Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $125.89 / $478.63	Professional		$77.62	$125.89	$478.63
Midlands Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $151.36 / $190.55	Professional		$117.49	$151.36	$190.55
Midlands Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $162.18	Professional		$144.54	$144.54	$162.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $134.90 / $169.82	Professional		$75.86	$134.90	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $91.20 / $162.18	Professional		$74.13	$91.20	$162.18
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $123.03 / $138.04	Professional		$104.71	$123.03	$138.04