Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.92 / $78.92 / $118.27	Facility		$78.92	$78.92	$118.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.11 / $71.23 / $115.06	Professional		$49.11	$71.23	$115.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $76.68 / $76.68 / $146.47	Facility		$76.68	$76.68	$146.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.68 / $139.22 / $181.54	Professional		$76.68	$139.22	$181.54
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $95.95 / $142.24 / $154.13	Professional		$95.95	$142.24	$154.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $71.23 / $171.67 / $469.03	Facility		$71.23	$171.67	$469.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $71.65 / $82.81 / $209.85	Professional		$71.65	$82.81	$209.85
Midlands Facility/Professional Facility Modifier Low / Median / High Price $146.47 / $157.00 / $199.98	Facility		$146.47	$157.00	$199.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $144.13 / $173.11 / $308.66	Professional		$144.13	$173.11	$308.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $97.41 / $104.33 / $175.89	Professional		$97.41	$104.33	$175.89
United Facility/Professional Facility Modifier Low / Median / High Price $59.18 / $71.01 / $85.22	Facility		$59.18	$71.01	$85.22
United Facility/Professional Professional Modifier Low / Median / High Price $71.01 / $79.81 / $173.60	Professional		$71.01	$79.81	$173.60
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $130.50 / $130.50 / $130.50	Facility		$130.50	$130.50	$130.50
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $103.10 / $130.50 / $130.50	Professional		$103.10	$130.50	$130.50