Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.80 / $86.61 / $2,508.23	Facility		$25.80	$86.61	$2,508.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.15 / $74.98 / $153.00	Professional		$40.15	$74.98	$153.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.64 / $86.64 / $182.83	Facility		$86.64	$86.64	$182.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.64 / $144.38 / $182.83	Professional		$86.64	$144.38	$182.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $124.66 / $166.47 / $199.48	Professional		$124.66	$166.47	$199.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $104.41 / $191.31 / $670.88	Facility		$104.41	$191.31	$670.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $62.19 / $82.92 / $218.01	Professional		$62.19	$82.92	$218.01
Midlands Facility/Professional Facility Modifier Low / Median / High Price $182.30 / $182.83 / $219.13	Facility		$182.30	$182.83	$219.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $143.11 / $213.57 / $349.40	Professional		$143.11	$213.57	$349.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $127.15 / $169.54 / $296.68	Professional		$127.15	$169.54	$296.68
United Facility/Professional Professional Modifier Low / Median / High Price $61.64 / $82.92 / $162.06	Professional		$61.64	$82.92	$162.06
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $157.90 / $157.90 / $157.90	Facility		$157.90	$157.90	$157.90
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $124.74 / $157.90 / $157.90	Professional		$124.74	$157.90	$157.90