Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.74 / $112.74 / $167.05	Facility		$112.74	$112.74	$167.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.22 / $75.95 / $114.61	Professional		$75.22	$75.95	$114.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $76.65 / $76.65 / $76.65	Facility		$76.65	$76.65	$76.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.22 / $91.72 / $116.51	Professional		$75.22	$91.72	$116.51
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $68.77 / $114.21 / $234.16	Professional		$68.77	$114.21	$234.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $75.93 / $99.75 / $154.44	Facility		$75.93	$99.75	$154.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.93 / $84.53 / $359.03	Professional		$75.93	$84.53	$359.03
Midlands Facility/Professional Facility Modifier Low / Median / High Price $91.72 / $118.16 / $166.32	Facility		$91.72	$118.16	$166.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $91.72 / $113.90 / $238.19	Professional		$91.72	$113.90	$238.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $75.22 / $149.31 / $158.40	Professional		$75.22	$149.31	$158.40
United Facility/Professional Professional Modifier Low / Median / High Price $75.22 / $77.48 / $89.51	Professional		$75.22	$77.48	$89.51
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $83.09 / $83.09 / $83.09	Facility		$83.09	$83.09	$83.09
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $65.64 / $83.09 / $83.09	Professional		$65.64	$83.09	$83.09