Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $71.55 / $108.00 / $108.00	Facility		$71.55	$108.00	$108.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.55 / $71.55 / $72.27	Professional		$71.55	$71.55	$72.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.10 / $47.91 / $85.86	Professional		$28.10	$47.91	$85.86
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $60.82 / $71.55 / $129.51	Professional		$60.82	$71.55	$129.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $19.59 / $85.86 / $110.90	Facility		$19.59	$85.86	$110.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $64.40 / $71.55 / $129.19	Professional		$64.40	$71.55	$129.19
Midlands Facility/Professional Facility Modifier Low / Median / High Price $38.43 / $57.98 / $85.86	Facility		$38.43	$57.98	$85.86
Midlands Facility/Professional Professional Modifier Low / Median / High Price $19.10 / $44.50 / $85.86	Professional		$19.10	$44.50	$85.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $22.60 / $24.70 / $27.20	Professional		$22.60	$24.70	$27.20
United Facility/Professional Professional Modifier Low / Median / High Price $71.55 / $71.55 / $88.29	Professional		$71.55	$71.55	$88.29
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $71.55 / $71.55 / $71.55	Facility		$71.55	$71.55	$71.55
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $56.52 / $71.55 / $71.55	Professional		$56.52	$71.55	$71.55