Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.30 / $62.30 / $110.99	Facility		$62.30	$62.30	$110.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.49 / $52.49 / $62.30	Professional		$52.49	$52.49	$62.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.43 / $56.94 / $72.20	Professional		$49.43	$56.94	$72.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $39.14 / $59.68 / $145.29	Professional		$39.14	$59.68	$145.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $50.45 / $62.30 / $87.81	Facility		$50.45	$62.30	$87.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $50.45 / $56.16 / $218.09	Professional		$50.45	$56.16	$218.09
Midlands Facility/Professional Facility Modifier Low / Median / High Price $58.24 / $75.68 / $98.81	Facility		$58.24	$75.68	$98.81
Midlands Facility/Professional Professional Modifier Low / Median / High Price $58.24 / $64.22 / $76.08	Professional		$58.24	$64.22	$76.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $53.75 / $104.02 / $109.65	Professional		$53.75	$104.02	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $52.49 / $54.06 / $62.46	Professional		$52.49	$54.06	$62.46
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $55.21 / $55.21 / $55.21	Facility		$55.21	$55.21	$55.21
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $43.62 / $55.21 / $55.21	Professional		$43.62	$55.21	$55.21