Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.70 / $69.59 / $69.59	Facility		$62.70	$69.59	$69.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.17 / $51.76 / $82.89	Professional		$40.17	$51.76	$82.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.85 / $53.85 / $122.18	Facility		$53.85	$53.85	$122.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.66 / $117.08 / $145.31	Professional		$93.66	$117.08	$145.31
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $95.15 / $115.68 / $124.99	Professional		$95.15	$115.68	$124.99
Medica Facility/Professional Facility Modifier Low / Median / High Price $69.78 / $122.18 / $456.49	Facility		$69.78	$122.18	$456.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.00 / $55.42 / $145.72	Professional		$43.00	$55.42	$145.72
Midlands Facility/Professional Facility Modifier Low / Median / High Price $121.82 / $122.18 / $146.43	Facility		$121.82	$122.18	$146.43
Midlands Facility/Professional Professional Modifier Low / Median / High Price $98.43 / $131.58 / $233.51	Professional		$98.43	$131.58	$233.51
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $102.16 / $113.29 / $198.26	Professional		$102.16	$113.29	$198.26
United Facility/Professional Professional Modifier Low / Median / High Price $42.61 / $55.42 / $130.21	Professional		$42.61	$55.42	$130.21
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $105.52 / $105.52 / $105.52	Facility		$105.52	$105.52	$105.52
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $83.36 / $105.52 / $105.52	Professional		$83.36	$105.52	$105.52