Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.15 / $84.15 / $172.63	Facility		$84.15	$84.15	$172.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.37 / $79.15 / $168.44	Professional		$78.37	$79.15	$168.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.37 / $78.98 / $113.45	Professional		$78.37	$78.98	$113.45
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $61.23 / $78.37 / $147.90	Professional		$61.23	$78.37	$147.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $73.72 / $84.15 / $132.61	Facility		$73.72	$84.15	$132.61
Medica Facility/Professional Professional Modifier Low / Median / High Price $78.47 / $87.35 / $933.66	Professional		$78.47	$87.35	$933.66
Midlands Facility/Professional Facility Modifier Low / Median / High Price $70.81 / $115.65 / $143.75	Facility		$70.81	$115.65	$143.75
Midlands Facility/Professional Professional Modifier Low / Median / High Price $70.81 / $96.16 / $118.73	Professional		$70.81	$96.16	$118.73
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $80.34 / $155.18 / $163.71	Professional		$80.34	$155.18	$163.71
United Facility/Professional Professional Modifier Low / Median / High Price $78.37 / $80.72 / $94.34	Professional		$78.37	$80.72	$94.34
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $85.87 / $85.87 / $85.87	Facility		$85.87	$85.87	$85.87
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $67.84 / $85.87 / $85.87	Professional		$67.84	$85.87	$85.87