Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $21.31 / $71.23 / $167.42	Facility		$21.31	$71.23	$167.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $11.22 / $99.00	Professional		$11.22	$11.22	$99.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.93 / $26.76 / $33.46	Professional		$16.93	$26.76	$33.46
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $14.57 / $25.50 / $75.78	Professional		$14.57	$25.50	$75.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $14.57 / $24.85 / $77.15	Facility		$14.57	$24.85	$77.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $8.74 / $15.01 / $39.90	Professional		$8.74	$15.01	$39.90
Midlands Facility/Professional Facility Modifier Low / Median / High Price $17.85 / $29.69 / $45.68	Facility		$17.85	$29.69	$45.68
Midlands Facility/Professional Professional Modifier Low / Median / High Price $17.51 / $29.69 / $39.90	Professional		$17.51	$29.69	$39.90
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $695.64 / $7,557.71 / $13,054.19	Facility		$695.64	$7,557.71	$13,054.19
United Facility/Professional Professional Modifier Low / Median / High Price $8.74 / $12.22 / $35.29	Professional		$8.74	$12.22	$35.29
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $11.51 / $14.57 / $14.57	Professional		$11.51	$14.57	$14.57