Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.13 / $60.13 / $114.49	Facility		$60.13	$60.13	$114.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.47 / $52.47 / $112.11	Professional		$52.47	$52.47	$112.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.86 / $56.93 / $74.93	Professional		$51.86	$56.93	$74.93
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $37.04 / $56.48 / $108.52	Professional		$37.04	$56.48	$108.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $52.04 / $60.13 / $87.95	Facility		$52.04	$60.13	$87.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.04 / $57.93 / $1,790.38	Professional		$52.04	$57.93	$1,790.38
Midlands Facility/Professional Facility Modifier Low / Median / High Price $57.89 / $76.38 / $100.56	Facility		$57.89	$76.38	$100.56
Midlands Facility/Professional Professional Modifier Low / Median / High Price $52.90 / $65.36 / $104.11	Professional		$52.90	$65.36	$104.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $53.11 / $103.98 / $109.61	Professional		$53.11	$103.98	$109.61
United Facility/Professional Professional Modifier Low / Median / High Price $52.47 / $54.04 / $62.44	Professional		$52.47	$54.04	$62.44
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $56.95 / $56.95 / $56.95	Facility		$56.95	$56.95	$56.95
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $44.99 / $56.95 / $56.95	Professional		$44.99	$56.95	$56.95