Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $66.07 / $181.97	Facility		$48.98	$66.07	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $52.48 / $83.18	Professional		$48.98	$52.48	$83.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $50.12 / $50.12	Facility		$50.12	$50.12	$50.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $63.10	Professional		$50.12	$50.12	$63.10
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $54.95 / $144.54	Professional		$48.98	$54.95	$144.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $52.48 / $74.13	Facility		$47.86	$52.48	$74.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $53.70 / $81.28	Professional		$46.77	$53.70	$81.28
Midlands Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $63.10 / $63.10	Professional		$57.54	$63.10	$63.10
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $2,570.40 / $2,570.40	Facility		$2,570.40	$2,570.40	$2,570.40
United Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $48.98 / $48.98	Facility		$48.98	$48.98	$48.98
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $51.29 / $54.95	Professional		$48.98	$51.29	$54.95
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $48.98 / $48.98	Facility		$48.98	$48.98	$48.98