Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.81 / $64.81 / $4,219.14	Facility		$64.81	$64.81	$4,219.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.96 / $64.81 / $110.54	Professional		$48.96	$64.81	$110.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $49.88 / $49.88 / $49.88	Facility		$49.88	$49.88	$49.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.28 / $50.52 / $61.59	Professional		$49.28	$50.52	$61.59
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $48.96 / $54.44 / $142.78	Professional		$48.96	$54.44	$142.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $48.03 / $57.41 / $74.45	Facility		$48.03	$57.41	$74.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $48.03 / $53.79 / $73.51	Professional		$48.03	$53.79	$73.51
Midlands Facility/Professional Facility Modifier Low / Median / High Price $53.00 / $73.51 / $104.56	Facility		$53.00	$73.51	$104.56
Midlands Facility/Professional Professional Modifier Low / Median / High Price $46.09 / $57.28 / $81.78	Professional		$46.09	$57.28	$81.78
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,556.61 / $2,556.61 / $2,556.61	Facility		$2,556.61	$2,556.61	$2,556.61
United Facility/Professional Professional Modifier Low / Median / High Price $48.96 / $51.41 / $54.84	Professional		$48.96	$51.41	$54.84
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $48.03 / $48.03 / $48.03	Facility		$48.03	$48.03	$48.03
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $48.03 / $48.03 / $48.03	Professional		$48.03	$48.03	$48.03