Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.76 / $73.59 / $73.59	Facility		$69.76	$73.59	$73.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.51 / $60.05 / $86.49	Professional		$42.51	$60.05	$86.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.32 / $61.21 / $107.70	Facility		$60.32	$61.21	$107.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.21 / $122.63 / $153.28	Professional		$61.21	$122.63	$153.28
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $93.01 / $101.90 / $114.60	Professional		$93.01	$101.90	$114.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $68.98 / $112.77 / $474.60	Facility		$68.98	$112.77	$474.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $46.81 / $53.12 / $133.79	Professional		$46.81	$53.12	$133.79
Midlands Facility/Professional Facility Modifier Low / Median / High Price $107.70 / $107.70 / $145.69	Facility		$107.70	$107.70	$145.69
Midlands Facility/Professional Professional Modifier Low / Median / High Price $107.40 / $129.09 / $205.84	Professional		$107.40	$129.09	$205.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $99.87 / $108.04 / $189.07	Professional		$99.87	$108.04	$189.07
United Facility/Professional Facility Modifier Low / Median / High Price $153.43 / $153.43 / $249.33	Facility		$153.43	$153.43	$249.33
United Facility/Professional Professional Modifier Low / Median / High Price $46.81 / $48.85 / $128.44	Professional		$46.81	$48.85	$128.44
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $93.01 / $93.01 / $93.01	Facility		$93.01	$93.01	$93.01
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $73.48 / $93.01 / $93.01	Professional		$73.48	$93.01	$93.01