Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.38 / $175.57 / $31,358.00	Facility		$137.38	$175.57	$31,358.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.34 / $91.34 / $205.09	Professional		$91.34	$91.34	$205.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.44 / $109.44 / $109.44	Facility		$109.44	$109.44	$109.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.09 / $99.10 / $128.66	Professional		$91.09	$99.10	$128.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $70.69 / $116.78 / $248.87	Professional		$70.69	$116.78	$248.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $91.02 / $112.52 / $155.72	Facility		$91.02	$112.52	$155.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $91.02 / $101.32 / $389.52	Professional		$91.02	$101.32	$389.52
Midlands Facility/Professional Facility Modifier Low / Median / High Price $107.27 / $135.86 / $178.52	Facility		$107.27	$135.86	$178.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $107.27 / $116.77 / $204.05	Professional		$107.27	$116.77	$204.05
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $93.91 / $181.00 / $190.80	Professional		$93.91	$181.00	$190.80
United Facility/Professional Professional Modifier Low / Median / High Price $91.34 / $94.08 / $108.69	Professional		$91.34	$94.08	$108.69
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $99.61 / $99.61 / $99.61	Facility		$99.61	$99.61	$99.61
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $78.69 / $99.61 / $99.61	Professional		$78.69	$99.61	$99.61