Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.38 / $76.48 / $106.97	Facility		$42.38	$76.48	$106.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.94 / $34.20 / $38.13	Professional		$25.94	$34.20	$38.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.21 / $71.81 / $89.76	Professional		$47.21	$71.81	$89.76
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $49.14 / $68.79 / $138.72	Professional		$49.14	$68.79	$138.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $39.31 / $50.73 / $104.96	Facility		$39.31	$50.73	$104.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $23.59 / $39.31 / $126.86	Professional		$23.59	$39.31	$126.86
Midlands Facility/Professional Facility Modifier Low / Median / High Price $47.17 / $72.06 / $87.35	Facility		$47.17	$72.06	$87.35
Midlands Facility/Professional Professional Modifier Low / Median / High Price $47.17 / $72.06 / $86.15	Professional		$47.17	$72.06	$86.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $39.31 / $39.31 / $70.17	Professional		$39.31	$39.31	$70.17
United Facility/Professional Professional Modifier Low / Median / High Price $23.59 / $23.59 / $80.48	Professional		$23.59	$23.59	$80.48
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $39.31 / $39.31 / $39.31	Professional		$39.31	$39.31	$39.31