Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.78 / $39.78 / $47.78	Facility		$39.78	$39.78	$47.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.48 / $34.85 / $54.94	Professional		$28.48	$34.85	$54.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.36 / $40.36 / $78.68	Facility		$40.36	$40.36	$78.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.36 / $71.63 / $90.96	Professional		$40.36	$71.63	$90.96
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $51.20 / $76.55 / $179.59	Professional		$51.20	$76.55	$179.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $34.85 / $94.01 / $283.33	Facility		$34.85	$94.01	$283.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $31.57 / $42.75 / $117.36	Professional		$31.57	$42.75	$117.36
Midlands Facility/Professional Facility Modifier Low / Median / High Price $78.68 / $80.25 / $110.23	Facility		$78.68	$80.25	$110.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $73.65 / $94.01 / $162.44	Professional		$73.65	$94.01	$162.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $25.10 / $124.70 / $185.90	Professional		$25.10	$124.70	$185.90
United Facility/Professional Professional Modifier Low / Median / High Price $30.37 / $34.85 / $65.83	Professional		$30.37	$34.85	$65.83
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $76.89 / $76.89 / $76.89	Facility		$76.89	$76.89	$76.89
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $60.74 / $76.89 / $76.89	Professional		$60.74	$76.89	$76.89