Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.78 / $53.48 / $75.72	Facility		$48.78	$53.48	$75.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.07 / $49.47 / $83.13	Professional		$34.07	$49.47	$83.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.14 / $67.14 / $97.82	Facility		$67.14	$67.14	$97.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.14 / $90.55 / $115.61	Professional		$67.14	$90.55	$115.61
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $64.47 / $79.80 / $109.09	Professional		$64.47	$79.80	$109.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $48.73 / $115.24 / $340.47	Facility		$48.73	$115.24	$340.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $48.73 / $57.37 / $134.66	Professional		$48.73	$57.37	$134.66
Midlands Facility/Professional Facility Modifier Low / Median / High Price $97.82 / $102.00 / $129.68	Facility		$97.82	$102.00	$129.68
Midlands Facility/Professional Professional Modifier Low / Median / High Price $92.48 / $115.61 / $206.89	Professional		$92.48	$115.61	$206.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $68.89 / $73.78 / $124.40	Professional		$68.89	$73.78	$124.40
United Facility/Professional Professional Modifier Low / Median / High Price $48.73 / $51.22 / $120.75	Professional		$48.73	$51.22	$120.75
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $87.15 / $87.15 / $87.15	Facility		$87.15	$87.15	$87.15
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $68.84 / $87.15 / $87.15	Professional		$68.84	$87.15	$87.15