Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.58 / $61.58 / $82.76	Facility		$61.58	$61.58	$82.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.82 / $54.72 / $95.66	Professional		$40.82	$54.72	$95.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.97 / $84.97 / $107.92	Facility		$84.97	$84.97	$107.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.97 / $94.12 / $117.65	Professional		$84.97	$94.12	$117.65
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $75.31 / $108.73 / $149.68	Professional		$75.31	$108.73	$149.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $53.90 / $126.88 / $370.47	Facility		$53.90	$126.88	$370.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $53.90 / $65.13 / $154.07	Professional		$53.90	$65.13	$154.07
Midlands Facility/Professional Facility Modifier Low / Median / High Price $107.92 / $112.30 / $147.72	Facility		$107.92	$112.30	$147.72
Midlands Facility/Professional Professional Modifier Low / Median / High Price $107.92 / $129.02 / $228.32	Professional		$107.92	$129.02	$228.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $76.45 / $81.88 / $138.05	Professional		$76.45	$81.88	$138.05
United Facility/Professional Professional Modifier Low / Median / High Price $53.90 / $56.45 / $144.66	Professional		$53.90	$56.45	$144.66
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $96.15 / $96.15 / $96.15	Facility		$96.15	$96.15	$96.15
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $75.95 / $96.15 / $96.15	Professional		$75.95	$96.15	$96.15