Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.73 / $78.73 / $107.60	Facility		$78.73	$78.73	$107.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.50 / $58.24 / $102.19	Professional		$36.50	$58.24	$102.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $70.80 / $70.80 / $156.10	Facility		$70.80	$70.80	$156.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.96 / $132.44 / $164.06	Professional		$105.96	$132.44	$164.06
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $113.31 / $122.85 / $177.36	Professional		$113.31	$122.85	$177.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $89.15 / $171.87 / $589.07	Facility		$89.15	$171.87	$589.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $56.53 / $70.79 / $186.13	Professional		$56.53	$70.79	$186.13
Midlands Facility/Professional Facility Modifier Low / Median / High Price $155.65 / $156.10 / $187.08	Facility		$155.65	$156.10	$187.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $126.05 / $182.34 / $298.30	Professional		$126.05	$182.34	$298.30
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $115.57 / $144.75 / $253.31	Professional		$115.57	$144.75	$253.31
United Facility/Professional Professional Modifier Low / Median / High Price $56.02 / $70.79 / $147.30	Professional		$56.02	$70.79	$147.30
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $134.81 / $134.81 / $134.81	Facility		$134.81	$134.81	$134.81
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $106.50 / $134.81 / $134.81	Professional		$106.50	$134.81	$134.81