Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.49 / $62.49 / $65.43	Facility		$62.49	$62.49	$65.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.34 / $54.02 / $83.46	Professional		$38.34	$54.02	$83.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.94 / $58.00 / $104.40	Facility		$56.94	$58.00	$104.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.00 / $104.25 / $130.31	Professional		$58.00	$104.25	$130.31
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $83.70 / $94.80 / $108.90	Professional		$83.70	$94.80	$108.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $59.62 / $109.32 / $472.21	Facility		$59.62	$109.32	$472.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.47 / $51.86 / $129.68	Professional		$44.47	$51.86	$129.68
Midlands Facility/Professional Facility Modifier Low / Median / High Price $104.10 / $104.40 / $136.62	Facility		$104.10	$104.40	$136.62
Midlands Facility/Professional Professional Modifier Low / Median / High Price $85.51 / $123.38 / $199.52	Professional		$85.51	$123.38	$199.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $91.73 / $98.24 / $169.41	Professional		$91.73	$98.24	$169.41
United Facility/Professional Professional Modifier Low / Median / High Price $44.47 / $47.35 / $111.65	Professional		$44.47	$47.35	$111.65
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $93.01 / $93.01 / $93.01	Facility		$93.01	$93.01	$93.01
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $73.48 / $93.01 / $93.01	Professional		$73.48	$93.01	$93.01