Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $131.83 / $194.98	Facility		$41.69	$131.83	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $42.66 / $72.44	Professional		$41.69	$42.66	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $75.86 / $85.11	Professional		$67.61	$75.86	$85.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $107.15 / $151.36	Professional		$57.54	$107.15	$151.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $75.86 / $120.23	Facility		$61.66	$75.86	$120.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $120.23	Professional		$50.12	$50.12	$120.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $75.86 / $120.23	Professional		$61.66	$75.86	$120.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $83.18	Professional		$83.18	$83.18	$83.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $102.33 / $120.23	Professional		$89.13	$102.33	$120.23
United Facility/Professional Facility Modifier Low / Median / High Price $0.05 / $0.05 / $83.18	Facility		$0.05	$0.05	$83.18
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $60.26	Professional		$50.12	$50.12	$60.26
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $75.86 / $75.86	Professional		$60.26	$75.86	$75.86