Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $94.14 / $94.14 / $131.43	Facility		$94.14	$94.14	$131.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.76 / $81.37 / $138.28	Professional		$55.76	$81.37	$138.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.70 / $86.88 / $149.04	Facility		$81.70	$86.88	$149.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.88 / $157.13 / $196.41	Professional		$86.88	$157.13	$196.41
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $128.72 / $152.85 / $168.15	Professional		$128.72	$152.85	$168.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $174.10 / $722.40	Facility		$85.11	$174.10	$722.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $64.77 / $76.37 / $185.11	Professional		$64.77	$76.37	$185.11
Midlands Facility/Professional Facility Modifier Low / Median / High Price $148.60 / $149.04 / $205.83	Facility		$148.60	$149.04	$205.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $134.00 / $174.10 / $284.81	Professional		$134.00	$174.10	$284.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $135.49 / $145.11 / $246.69	Professional		$135.49	$145.11	$246.69
United Facility/Professional Professional Modifier Low / Median / High Price $64.77 / $67.59 / $159.38	Professional		$64.77	$67.59	$159.38
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $132.78 / $132.78 / $132.78	Facility		$132.78	$132.78	$132.78
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $104.90 / $132.78 / $132.78	Professional		$104.90	$132.78	$132.78