Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $63.10 / $114.82	Facility		$57.54	$63.10	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $61.66 / $72.44	Professional		$57.54	$61.66	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $64.57 / $91.20	Professional		$61.66	$64.57	$91.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $120.23 / $186.21	Professional		$100.00	$120.23	$186.21
Medica Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $63.10 / $239.88	Facility		$57.54	$63.10	$239.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $67.61 / $2,630.27	Professional		$60.26	$67.61	$2,630.27
Midlands Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $239.88 / $281.84	Professional		$85.11	$239.88	$281.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $114.82 / $162.18	Professional		$56.23	$114.82	$162.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $83.18 / $144.54	Professional		$30.20	$83.18	$144.54
United Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Facility		$61.66	$61.66	$61.66
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $72.44	Professional		$60.26	$60.26	$72.44
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Facility		$69.18	$69.18	$69.18
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $69.18 / $69.18	Professional		$54.95	$69.18	$69.18