Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $18.20 / $18.20 / $30.20	Facility		$18.20	$18.20	$30.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $23.99 / $112.20	Professional		$10.96	$23.99	$112.20
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $169.82 / $169.82 / $169.82	Professional	50	$169.82	$169.82	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $39.81 / $58.88	Professional		$25.70	$39.81	$58.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $29.51 / $87.10	Professional		$11.75	$29.51	$87.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $47.86 / $1,148.15	Facility		$19.05	$47.86	$1,148.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $45.71 / $199.53	Professional		$21.88	$45.71	$199.53
Midlands Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $44.67 / $70.79	Professional		$27.54	$44.67	$70.79
Midlands Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $38.02 / $58.88	Professional		$37.15	$38.02	$58.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $20.42 / $40.74	Professional		$10.23	$20.42	$40.74
United Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $1,202.26 / $2,344.23	Facility		$128.82	$1,202.26	$2,344.23
United Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $27.54 / $53.70	Professional		$12.88	$27.54	$53.70
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $25.12 / $44.67	Professional		$21.38	$25.12	$44.67