Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.07 / $93.07 / $153.65	Facility		$93.07	$93.07	$153.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.37 / $72.06 / $147.47	Professional		$71.37	$72.06	$147.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.51 / $85.51 / $85.51	Facility		$85.51	$85.51	$85.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.89 / $77.43 / $96.57	Professional		$68.89	$77.43	$96.57
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $56.77 / $78.51 / $159.04	Professional		$56.77	$78.51	$159.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $69.84 / $83.39 / $118.03	Facility		$69.84	$83.39	$118.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $69.84 / $77.75 / $288.38	Professional		$69.84	$77.75	$288.38
Midlands Facility/Professional Facility Modifier Low / Median / High Price $78.38 / $100.59 / $129.59	Facility		$78.38	$100.59	$129.59
Midlands Facility/Professional Professional Modifier Low / Median / High Price $72.92 / $84.91 / $137.78	Professional		$72.92	$84.91	$137.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $71.37 / $141.43 / $149.09	Professional		$71.37	$141.43	$149.09
United Facility/Professional Professional Modifier Low / Median / High Price $71.37 / $73.51 / $84.93	Professional		$71.37	$73.51	$84.93
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $76.42 / $76.42 / $76.42	Facility		$76.42	$76.42	$76.42
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $60.37 / $76.42 / $76.42	Professional		$60.37	$76.42	$76.42