Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $94.95 / $94.95 / $4,636.10	Facility		$94.95	$94.95	$4,636.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.41 / $65.41 / $94.95	Professional		$65.41	$65.41	$94.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.99 / $54.99 / $59.07	Facility		$54.99	$54.99	$59.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.49 / $66.64 / $85.03	Professional		$51.49	$66.64	$85.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $55.60 / $65.41 / $118.39	Professional		$55.60	$65.41	$118.39
Medica Facility/Professional Facility Modifier Low / Median / High Price $53.00 / $85.03 / $100.73	Facility		$53.00	$85.03	$100.73
Medica Facility/Professional Professional Modifier Low / Median / High Price $65.41 / $65.41 / $130.82	Professional		$65.41	$65.41	$130.82
Midlands Facility/Professional Facility Modifier Low / Median / High Price $48.00 / $78.48 / $98.11	Facility		$48.00	$78.48	$98.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $45.49 / $75.30 / $95.21	Professional		$45.49	$75.30	$95.21
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $55.10 / $66.40 / $96.10	Professional		$55.10	$66.40	$96.10
United Facility/Professional Professional Modifier Low / Median / High Price $65.41 / $65.41 / $71.95	Professional		$65.41	$65.41	$71.95
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $65.41 / $65.41 / $65.41	Facility		$65.41	$65.41	$65.41
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $51.67 / $65.41 / $65.41	Professional		$51.67	$65.41	$65.41