Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Facility		$131.83	$131.83	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $70.79 / $223.87	Professional		$56.23	$70.79	$223.87
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $67.61 / $186.21 / $288.40	Professional	25	$67.61	$186.21	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $117.49 / $194.98	Professional		$64.57	$117.49	$194.98
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $102.33 / $223.87	Professional		$63.10	$102.33	$223.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $66.07 / $134.90	Facility		$54.95	$66.07	$134.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $114.82 / $457.09	Professional		$72.44	$114.82	$457.09
Midlands Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $138.04 / $169.82	Professional		$102.33	$138.04	$169.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $144.54 / $194.98	Professional		$114.82	$144.54	$194.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $117.49 / $169.82	Professional		$66.07	$117.49	$169.82
United Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $93.33	Facility		$91.20	$91.20	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $93.33 / $151.36	Professional		$69.18	$93.33	$151.36
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $100.00 / $102.33	Professional		$79.43	$100.00	$102.33