Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $54.95 / $67.61	Facility		$48.98	$54.95	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $57.54 / $79.43	Professional		$43.65	$57.54	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $123.03 / $251.19	Professional		$85.11	$123.03	$251.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $64.57 / $177.83	Professional		$52.48	$64.57	$177.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $70.79 / $123.03	Facility		$54.95	$70.79	$123.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $79.43 / $213.80	Professional		$52.48	$79.43	$213.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $123.03 / $154.88	Professional		$85.11	$123.03	$154.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $81.28 / $169.82	Professional		$67.61	$81.28	$169.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $60.26 / $89.13	Professional		$50.12	$60.26	$89.13
United Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $47.86 / $47.86	Facility		$47.86	$47.86	$47.86
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $74.13 / $138.04	Professional		$53.70	$74.13	$138.04
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $100.00 / $112.20	Professional		$89.13	$100.00	$112.20