Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.47 / $120.58 / $205.53	Facility		$83.47	$120.58	$205.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.47 / $55.47 / $56.58	Professional		$55.47	$55.47	$56.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.39 / $55.94 / $78.89	Professional		$55.39	$55.94	$78.89
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $55.47 / $95.65 / $141.51	Professional		$55.47	$95.65	$141.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $55.30 / $62.80 / $99.37	Facility		$55.30	$62.80	$99.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $55.30 / $61.56 / $239.05	Professional		$55.30	$61.56	$239.05
Midlands Facility/Professional Facility Modifier Low / Median / High Price $65.25 / $83.38 / $104.85	Facility		$65.25	$83.38	$104.85
Midlands Facility/Professional Professional Modifier Low / Median / High Price $64.28 / $70.38 / $83.74	Professional		$64.28	$70.38	$83.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $56.18 / $109.92 / $115.87	Professional		$56.18	$109.92	$115.87
United Facility/Professional Facility Modifier Low / Median / High Price $55.47 / $55.47 / $55.47	Facility		$55.47	$55.47	$55.47
United Facility/Professional Professional Modifier Low / Median / High Price $55.47 / $57.13 / $66.01	Professional		$55.47	$57.13	$66.01
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $60.52 / $60.52 / $60.52	Facility		$60.52	$60.52	$60.52
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $47.81 / $60.52 / $60.52	Professional		$47.81	$60.52	$60.52