Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $64.57 / $389.05	Facility		$23.44	$64.57	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $58.88 / $177.83	Professional		$28.84	$58.88	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $79.43 / $107.15	Professional		$50.12	$79.43	$107.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $53.70 / $125.89	Professional		$27.54	$53.70	$125.89
Medica Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $79.43 / $1,148.15	Facility		$44.67	$79.43	$1,148.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $79.43 / $234.42	Professional		$41.69	$79.43	$234.42
Midlands Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $79.43 / $112.20	Professional		$66.07	$79.43	$112.20
Midlands Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $79.43 / $112.20	Professional		$54.95	$79.43	$112.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $50.12 / $95.50	Professional		$28.18	$50.12	$95.50
United Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $1,202.26 / $2,344.23	Facility		$288.40	$1,202.26	$2,344.23
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $50.12 / $97.72	Professional		$30.20	$50.12	$97.72
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $66.07 / $97.72	Professional		$56.23	$66.07	$97.72