Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.63 / $50.63 / $74.48	Facility		$50.63	$50.63	$74.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.09 / $45.69 / $69.81	Professional		$29.09	$45.69	$69.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.67 / $57.67 / $90.22	Facility		$57.67	$57.67	$90.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.00 / $90.00 / $118.14	Professional		$72.00	$90.00	$118.14
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $53.86 / $95.84 / $103.86	Professional		$53.86	$95.84	$103.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $45.69 / $106.63 / $275.93	Facility		$45.69	$106.63	$275.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $45.05 / $52.07 / $131.93	Professional		$45.05	$52.07	$131.93
Midlands Facility/Professional Facility Modifier Low / Median / High Price $90.22 / $97.37 / $123.02	Facility		$90.22	$97.37	$123.02
Midlands Facility/Professional Professional Modifier Low / Median / High Price $90.22 / $106.63 / $189.75	Professional		$90.22	$106.63	$189.75
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $55.32 / $63.89 / $111.04	Professional		$55.32	$63.89	$111.04
United Facility/Professional Professional Modifier Low / Median / High Price $44.65 / $50.18 / $131.93	Professional		$44.65	$50.18	$131.93
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $80.38 / $80.38 / $80.38	Facility		$80.38	$80.38	$80.38
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $63.50 / $80.38 / $80.38	Professional		$63.50	$80.38	$80.38