Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.57 / $34.00 / $114.39	Facility		$15.57	$34.00	$114.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.94 / $10.43 / $87.06	Professional		$8.94	$10.43	$87.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.69 / $24.81 / $31.01	Professional		$15.69	$24.81	$31.01
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $13.54 / $23.70 / $101.15	Professional		$13.54	$23.70	$101.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $13.54 / $22.72 / $65.48	Facility		$13.54	$22.72	$65.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $8.11 / $13.95 / $36.57	Professional		$8.11	$13.95	$36.57
Midlands Facility/Professional Facility Modifier Low / Median / High Price $16.60 / $27.60 / $42.45	Facility		$16.60	$27.60	$42.45
Midlands Facility/Professional Professional Modifier Low / Median / High Price $16.26 / $27.60 / $38.83	Professional		$16.26	$27.60	$38.83
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,643.86 / $1,643.86 / $1,643.86	Facility		$1,643.86	$1,643.86	$1,643.86
United Facility/Professional Professional Modifier Low / Median / High Price $8.11 / $11.06 / $34.24	Professional		$8.11	$11.06	$34.24
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $10.70 / $13.54 / $13.54	Professional		$10.70	$13.54	$13.54