Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $56.23 / $208.93	Facility		$54.95	$56.23	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $177.83	Professional		$54.95	$54.95	$177.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $83.18 / $83.18	Facility		$83.18	$83.18	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $56.23 / $70.79	Professional		$54.95	$56.23	$70.79
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $154.88 / $251.19	Professional		$58.88	$154.88	$251.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $79.43 / $131.83	Facility		$77.62	$79.43	$131.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $81.28 / $316.23	Professional		$77.62	$81.28	$316.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $89.13 / $93.33	Professional		$43.65	$89.13	$93.33
Midlands Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $93.33 / $223.87	Professional		$43.65	$93.33	$223.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $97.72 / $120.23	Professional		$60.26	$97.72	$120.23
United Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $57.54 / $74.13	Professional		$54.95	$57.54	$74.13
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Facility		$69.18	$69.18	$69.18
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $69.18 / $69.18	Professional		$54.95	$69.18	$69.18