Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.51 / $62.51 / $139.16	Facility		$62.51	$62.51	$139.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.92 / $60.09 / $162.28	Professional		$57.92	$60.09	$162.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.54 / $65.83 / $260.27	Professional		$61.54	$65.83	$260.27
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $86.87 / $142.25 / $177.12	Professional		$86.87	$142.25	$177.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $57.92 / $64.87 / $240.66	Facility		$57.92	$64.87	$240.66
Medica Facility/Professional Professional Modifier Low / Median / High Price $60.34 / $67.17 / $2,649.11	Professional		$60.34	$67.17	$2,649.11
Midlands Facility/Professional Facility Modifier Low / Median / High Price $85.51 / $124.72 / $283.20	Facility		$85.51	$124.72	$283.20
Midlands Facility/Professional Professional Modifier Low / Median / High Price $68.11 / $115.30 / $279.24	Professional		$68.11	$115.30	$279.24
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $73.09 / $109.00 / $282.10	Professional		$73.09	$109.00	$282.10
United Facility/Professional Professional Modifier Low / Median / High Price $60.34 / $62.15 / $71.80	Professional		$60.34	$62.15	$71.80
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $69.98 / $69.98 / $69.98	Facility		$69.98	$69.98	$69.98
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $55.29 / $69.98 / $69.98	Professional		$55.29	$69.98	$69.98