Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $24.52 / $64.28 / $151.32	Facility		$24.52	$64.28	$151.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.91 / $29.38 / $103.14	Professional		$12.91	$29.38	$103.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.41 / $30.68 / $38.35	Professional		$19.41	$30.68	$38.35
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $16.77 / $29.35 / $81.09	Professional		$16.77	$29.35	$81.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $16.77 / $28.60 / $80.19	Facility		$16.77	$28.60	$80.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $10.06 / $16.77 / $43.77	Professional		$10.06	$16.77	$43.77
Midlands Facility/Professional Facility Modifier Low / Median / High Price $20.55 / $34.18 / $52.57	Facility		$20.55	$34.18	$52.57
Midlands Facility/Professional Professional Modifier Low / Median / High Price $20.14 / $34.18 / $48.07	Professional		$20.14	$34.18	$48.07
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $103.79 / $934.58 / $1,614.26	Facility		$103.79	$934.58	$1,614.26
United Facility/Professional Facility Modifier Low / Median / High Price $16.77 / $16.77 / $16.77	Facility		$16.77	$16.77	$16.77
United Facility/Professional Professional Modifier Low / Median / High Price $10.06 / $14.06 / $38.57	Professional		$10.06	$14.06	$38.57
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $13.25 / $16.77 / $16.77	Professional		$13.25	$16.77	$16.77