Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $83.18 / $147.91	Facility		$74.13	$83.18	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $74.13 / $123.03	Professional		$72.44	$74.13	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $75.86 / $93.33	Professional		$74.13	$75.86	$93.33
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $109.65 / $165.96	Professional		$63.10	$109.65	$165.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $83.18 / $125.89	Facility		$74.13	$83.18	$125.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $81.28 / $309.03	Professional		$74.13	$81.28	$309.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $91.20 / $109.65	Professional		$83.18	$91.20	$109.65
Midlands Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $100.00 / $141.25	Professional		$83.18	$100.00	$141.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $131.83 / $158.49	Professional		$79.43	$131.83	$158.49
United Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Facility		$74.13	$74.13	$74.13
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $87.10	Professional		$74.13	$74.13	$87.10
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Facility		$81.28	$81.28	$81.28
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $81.28 / $81.28	Professional		$64.57	$81.28	$81.28