Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.58 / $62.58 / $139.12	Facility		$62.58	$62.58	$139.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.90 / $60.08 / $62.58	Professional		$57.90	$60.08	$62.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.52 / $101.24 / $130.31	Professional		$61.52	$101.24	$130.31
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $82.00 / $99.10 / $141.69	Professional		$82.00	$99.10	$141.69
Medica Facility/Professional Facility Modifier Low / Median / High Price $57.90 / $71.19 / $127.39	Facility		$57.90	$71.19	$127.39
Medica Facility/Professional Professional Modifier Low / Median / High Price $60.32 / $60.32 / $477.55	Professional		$60.32	$60.32	$477.55
Midlands Facility/Professional Facility Modifier Low / Median / High Price $71.19 / $93.08 / $131.46	Facility		$71.19	$93.08	$131.46
Midlands Facility/Professional Professional Modifier Low / Median / High Price $71.19 / $97.28 / $141.72	Professional		$71.19	$97.28	$141.72
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $77.80 / $112.60 / $160.30	Professional		$77.80	$112.60	$160.30
United Facility/Professional Professional Modifier Low / Median / High Price $60.32 / $60.32 / $62.13	Professional		$60.32	$60.32	$62.13
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $59.12 / $59.12 / $59.12	Facility		$59.12	$59.12	$59.12
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $46.70 / $59.12 / $59.12	Professional		$46.70	$59.12	$59.12