Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.90 / $61.90 / $121.20	Facility		$61.90	$61.90	$121.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.65 / $57.89 / $102.70	Professional		$55.65	$57.89	$102.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.84 / $55.65 / $69.64	Professional		$52.84	$55.65	$69.64
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $43.15 / $55.65 / $109.50	Professional		$43.15	$55.65	$109.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $51.57 / $61.70 / $91.83	Facility		$51.57	$61.70	$91.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $55.09 / $60.60 / $2,122.62	Professional		$55.09	$60.60	$2,122.62
Midlands Facility/Professional Facility Modifier Low / Median / High Price $60.24 / $77.77 / $93.55	Facility		$60.24	$77.77	$93.55
Midlands Facility/Professional Professional Modifier Low / Median / High Price $44.51 / $64.81 / $82.64	Professional		$44.51	$64.81	$82.64
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $55.65 / $110.28 / $116.25	Professional		$55.65	$110.28	$116.25
United Facility/Professional Professional Modifier Low / Median / High Price $55.65 / $57.32 / $66.22	Professional		$55.65	$57.32	$66.22
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $60.29 / $60.29 / $60.29	Facility		$60.29	$60.29	$60.29
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $47.63 / $60.29 / $60.29	Professional		$47.63	$60.29	$60.29