Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $89.13	Facility		$74.13	$74.13	$89.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $64.57 / $114.82	Professional		$53.70	$64.57	$114.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $131.83	Facility		$75.86	$75.86	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $134.90 / $169.82	Professional		$75.86	$134.90	$169.82
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $204.17 / $218.78	Professional		$112.20	$204.17	$218.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $151.36 / $602.56	Facility		$81.28	$151.36	$602.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $75.86 / $199.53	Professional		$56.23	$75.86	$199.53
Midlands Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $134.90 / $177.83	Professional		$128.82	$134.90	$177.83
Midlands Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Facility		$131.83	$131.83	$131.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $199.53 / $199.53	Professional		$131.83	$199.53	$199.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $154.88 / $257.04	Professional		$120.23	$154.88	$257.04
United Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $87.10 / $190.55	Facility		$44.67	$87.10	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $58.88 / $107.15	Professional		$56.23	$58.88	$107.15
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $114.82 / $114.82	Professional		$91.20	$114.82	$114.82