Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $61.66 / $72.44	Facility		$61.66	$61.66	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $61.66 / $177.83	Professional		$42.66	$61.66	$177.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $61.66 / $109.65	Facility		$60.26	$61.66	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $123.03 / $154.88	Professional		$61.66	$123.03	$154.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $102.33 / $123.03	Professional		$89.13	$102.33	$123.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $125.89 / $478.63	Facility		$69.18	$125.89	$478.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $64.57 / $162.18	Professional		$47.86	$64.57	$162.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $125.89 / $245.47	Professional		$107.15	$125.89	$245.47
Midlands Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Facility		$109.65	$109.65	$109.65
Midlands Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Professional		$162.18	$162.18	$162.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $141.25 / $213.80	Professional		$100.00	$141.25	$213.80
United Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $72.44 / $154.88	Facility		$37.15	$72.44	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $48.98 / $87.10	Professional		$47.86	$48.98	$87.10
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $93.33 / $93.33	Professional		$74.13	$93.33	$93.33