Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.43 / $81.43 / $90.73	Facility		$81.43	$81.43	$90.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.69 / $69.63 / $117.56	Professional		$55.69	$69.63	$117.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.81 / $75.81 / $129.68	Facility		$75.81	$75.81	$129.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.81 / $135.75 / $169.69	Professional		$75.81	$135.75	$169.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $111.34 / $137.87 / $220.20	Professional		$111.34	$137.87	$220.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $74.06 / $151.47 / $608.40	Facility		$74.06	$151.47	$608.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $56.36 / $65.34 / $161.07	Professional		$56.36	$65.34	$161.07
Midlands Facility/Professional Facility Modifier Low / Median / High Price $129.30 / $129.68 / $176.13	Facility		$129.30	$129.68	$176.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $106.32 / $153.26 / $247.81	Professional		$106.32	$153.26	$247.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $117.89 / $126.26 / $213.38	Professional		$117.89	$126.26	$213.38
United Facility/Professional Facility Modifier Low / Median / High Price $88.00 / $88.00 / $88.00	Facility		$88.00	$88.00	$88.00
United Facility/Professional Professional Modifier Low / Median / High Price $56.36 / $58.81 / $138.66	Professional		$56.36	$58.81	$138.66
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $115.53 / $115.53 / $115.53	Facility		$115.53	$115.53	$115.53
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $91.27 / $115.53 / $115.53	Professional		$91.27	$115.53	$115.53