Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $128.82 / $478.63	Facility		$47.86	$128.82	$478.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $64.57 / $302.00	Professional		$36.31	$64.57	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $91.20 / $114.82	Professional		$67.61	$91.20	$114.82
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $102.33 / $213.80	Professional		$47.86	$102.33	$213.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $61.66 / $194.98	Facility		$47.86	$61.66	$194.98
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $52.48 / $120.23	Professional		$28.84	$52.48	$120.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $61.66 / $67.61	Professional		$57.54	$61.66	$67.61
Midlands Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $67.61	Facility		$67.61	$67.61	$67.61
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $1,621.81 / $4,570.88	Facility		$251.19	$1,621.81	$4,570.88
United Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $47.86 / $104.71	Facility		$47.86	$47.86	$104.71
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $35.48 / $114.82	Professional		$28.84	$35.48	$114.82
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $47.86 / $47.86	Professional		$38.02	$47.86	$47.86