Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.94 / $97.00 / $172.57	Facility		$77.94	$97.00	$172.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.87 / $55.15 / $86.89	Professional		$25.87	$55.15	$86.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.38 / $79.22 / $131.25	Professional		$63.38	$79.22	$131.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $27.14 / $49.05 / $96.80	Professional		$27.14	$49.05	$96.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $34.52 / $60.13 / $153.50	Facility		$34.52	$60.13	$153.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $68.84 / $104.09 / $296.08	Professional		$68.84	$104.09	$296.08
Midlands Facility/Professional Facility Modifier Low / Median / High Price $47.07 / $82.01 / $140.62	Facility		$47.07	$82.01	$140.62
Midlands Facility/Professional Professional Modifier Low / Median / High Price $47.07 / $88.82 / $154.34	Professional		$47.07	$88.82	$154.34
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $53.82 / $60.48 / $102.19	Professional		$53.82	$60.48	$102.19
United Facility/Professional Professional Modifier Low / Median / High Price $68.86 / $100.16 / $170.27	Professional		$68.86	$100.16	$170.27
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $48.60 / $58.90 / $99.60	Professional		$48.60	$58.90	$99.60