Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $28.84 / $47.86	Facility		$28.84	$28.84	$47.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $31.62 / $70.79	Professional		$16.98	$31.62	$70.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $70.79 / $87.10	Professional		$42.66	$70.79	$87.10
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $38.02 / $125.89	Professional		$19.05	$38.02	$125.89
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $74.13 / $1,148.15	Facility		$30.20	$74.13	$1,148.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $70.79 / $316.23	Professional		$35.48	$70.79	$316.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $69.18 / $95.50	Professional		$44.67	$69.18	$95.50
Midlands Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $72.44 / $100.00	Professional		$57.54	$72.44	$100.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $29.51 / $58.88	Professional		$15.85	$29.51	$58.88
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 $21.88 / $44.67 / $83.18	Professional		$21.88	$44.67	$83.18
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $40.74 / $66.07	Professional		$34.67	$40.74	$66.07