Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $64.57	Facility		$58.88	$58.88	$64.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $61.66 / $147.91	Professional		$41.69	$61.66	$147.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $107.15	Facility		$57.54	$57.54	$107.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $104.71 / $128.82	Professional		$57.54	$104.71	$128.82
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $95.50 / $112.20	Professional		$79.43	$95.50	$112.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $120.23 / $467.74	Facility		$64.57	$120.23	$467.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $58.88 / $158.49	Professional		$44.67	$58.88	$158.49
Midlands Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $109.65 / $138.04	Professional		$104.71	$109.65	$138.04
Midlands Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Facility		$107.15	$107.15	$107.15
Midlands Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $158.49 / $158.49	Professional		$102.33	$158.49	$158.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $125.89 / $194.98	Professional		$91.20	$125.89	$194.98
United Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $58.88 / $147.91	Facility		$34.67	$58.88	$147.91
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $47.86 / $87.10	Professional		$44.67	$47.86	$87.10
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $93.33 / $93.33	Professional		$74.13	$93.33	$93.33