Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.55 / $82.55 / $82.55	Facility		$82.55	$82.55	$82.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.55 / $71.12 / $92.50	Professional		$57.55	$71.12	$92.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.30 / $94.22 / $161.66	Professional		$61.30	$94.22	$161.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $56.13 / $99.05 / $197.31	Professional		$56.13	$99.05	$197.31
Medica Facility/Professional Facility Modifier Low / Median / High Price $67.11 / $99.95 / $159.79	Facility		$67.11	$99.95	$159.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $78.02 / $128.18 / $440.72	Professional		$78.02	$128.18	$440.72
Midlands Facility/Professional Facility Modifier Low / Median / High Price $87.35 / $112.00 / $163.61	Facility		$87.35	$112.00	$163.61
Midlands Facility/Professional Professional Modifier Low / Median / High Price $87.35 / $116.39 / $178.88	Professional		$87.35	$116.39	$178.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $87.30 / $130.00 / $185.80	Professional		$87.30	$130.00	$185.80
United Facility/Professional Professional Modifier Low / Median / High Price $75.43 / $121.29 / $192.93	Professional		$75.43	$121.29	$192.93
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $76.23 / $96.50 / $113.50	Professional		$76.23	$96.50	$113.50