Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.11 / $42.11 / $50.44	Facility		$42.11	$42.11	$50.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.93 / $36.81 / $58.15	Professional		$30.93	$36.81	$58.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.23 / $44.23 / $82.36	Facility		$44.23	$44.23	$82.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.23 / $78.00 / $98.27	Professional		$44.23	$78.00	$98.27
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $62.50 / $121.56 / $159.30	Professional		$62.50	$121.56	$159.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $64.83 / $99.64 / $310.80	Facility		$64.83	$99.64	$310.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.58 / $46.47 / $121.34	Professional		$34.58	$46.47	$121.34
Midlands Facility/Professional Facility Modifier Low / Median / High Price $82.36 / $83.88 / $114.98	Facility		$82.36	$83.88	$114.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $81.16 / $98.27 / $166.21	Professional		$81.16	$98.27	$166.21
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $72.30 / $131.50 / $191.20	Professional		$72.30	$131.50	$191.20
United Facility/Professional Facility Modifier Low / Median / High Price $32.10 / $42.60 / $57.74	Facility		$32.10	$42.60	$57.74
United Facility/Professional Professional Modifier Low / Median / High Price $34.58 / $38.43 / $76.08	Professional		$34.58	$38.43	$76.08
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $80.48 / $80.48 / $80.48	Facility		$80.48	$80.48	$80.48
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $63.59 / $80.48 / $80.48	Professional		$63.59	$80.48	$80.48