Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.80 / $106.80 / $116.87	Facility		$106.80	$106.80	$116.87
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $79.17 / $79.17 / $79.17	Facility	25	$79.17	$79.17	$79.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.90 / $76.65 / $259.68	Professional		$61.90	$76.65	$259.68
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $60.27 / $81.42 / $266.29	Professional	25	$60.27	$81.42	$266.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.09 / $140.52 / $183.28	Professional		$78.09	$140.52	$183.28
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $75.79 / $113.69 / $196.23	Professional		$75.79	$113.69	$196.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $64.95 / $88.29 / $164.28	Facility		$64.95	$88.29	$164.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $90.59 / $150.13 / $477.95	Professional		$90.59	$150.13	$477.95
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $149.99 / $149.99 / $149.99	Professional	25	$149.99	$149.99	$149.99
Midlands Facility/Professional Facility Modifier Low / Median / High Price $108.69 / $150.13 / $201.28	Facility		$108.69	$150.13	$201.28
Midlands Facility/Professional Professional Modifier Low / Median / High Price $108.69 / $148.78 / $164.28	Professional		$108.69	$148.78	$164.28
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $68.90 / $122.99 / $152.72	Professional		$68.90	$122.99	$152.72
United Facility/Professional Professional Modifier Low / Median / High Price $86.47 / $114.69 / $191.22	Professional		$86.47	$114.69	$191.22
United Facility/Professional Professional Modifier 25 Low / Median / High Price $99.10 / $99.10 / $99.10	Professional	25	$99.10	$99.10	$99.10
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $90.10 / $106.00 / $116.40	Professional		$90.10	$106.00	$116.40