Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.57 / $54.90 / $54.90	Facility		$47.57	$54.90	$54.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.34 / $40.61 / $58.94	Professional		$27.34	$40.61	$58.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $46.70 / $46.70 / $85.37	Facility		$46.70	$46.70	$85.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.70 / $91.50 / $114.38	Professional		$46.70	$91.50	$114.38
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $65.98 / $90.74 / $100.02	Professional		$65.98	$90.74	$100.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $48.75 / $89.30 / $352.17	Facility		$48.75	$89.30	$352.17
Medica Facility/Professional Professional Modifier Low / Median / High Price $32.61 / $38.79 / $102.73	Professional		$32.61	$38.79	$102.73
Midlands Facility/Professional Facility Modifier Low / Median / High Price $85.13 / $85.37 / $102.32	Facility		$85.13	$85.37	$102.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $69.91 / $99.32 / $163.13	Professional		$69.91	$99.32	$163.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $79.02 / $84.63 / $141.30	Professional		$79.02	$84.63	$141.30
United Facility/Professional Facility Modifier Low / Median / High Price $104.62 / $104.62 / $170.00	Facility		$104.62	$104.62	$170.00
United Facility/Professional Professional Modifier Low / Median / High Price $32.33 / $38.72 / $91.35	Professional		$32.33	$38.72	$91.35
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $73.73 / $73.73 / $73.73	Facility		$73.73	$73.73	$73.73
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $58.25 / $73.73 / $73.73	Professional		$58.25	$73.73	$73.73