Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.57 / $82.57 / $160.71	Facility		$82.57	$82.57	$160.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.20 / $76.15 / $196.81	Professional		$73.20	$76.15	$196.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.71 / $87.71 / $87.71	Facility		$87.71	$87.71	$87.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.20 / $79.42 / $108.69	Professional		$73.20	$79.42	$108.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $73.20 / $99.87 / $247.12	Professional		$73.20	$99.87	$247.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $73.05 / $82.57 / $124.19	Facility		$73.05	$82.57	$124.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $73.05 / $81.31 / $2,022.25	Professional		$73.05	$81.31	$2,022.25
Midlands Facility/Professional Facility Modifier Low / Median / High Price $87.27 / $109.79 / $144.44	Facility		$87.27	$109.79	$144.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $87.27 / $98.27 / $121.92	Professional		$87.27	$98.27	$121.92
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $73.63 / $145.06 / $152.91	Professional		$73.63	$145.06	$152.91
United Facility/Professional Professional Modifier Low / Median / High Price $73.20 / $75.40 / $95.63	Professional		$73.20	$75.40	$95.63
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $79.94 / $79.94 / $79.94	Facility		$79.94	$79.94	$79.94
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $63.15 / $79.94 / $79.94	Professional		$63.15	$79.94	$79.94