Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $18.20 / $52.48 / $114.82	Facility		$18.20	$52.48	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $25.70 / $114.82	Professional		$15.14	$25.70	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $40.74 / $51.29	Professional		$25.12	$40.74	$51.29
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $38.02 / $52.48	Professional		$20.89	$38.02	$52.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $26.30 / $75.86	Facility		$20.89	$26.30	$75.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $20.89 / $45.71	Professional		$12.59	$20.89	$45.71
Midlands Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $25.12 / $26.92	Professional		$19.05	$25.12	$26.92
Midlands Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $19.05 / $19.05	Facility		$19.05	$19.05	$19.05
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Facility		$144.54	$144.54	$144.54
United Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $20.89 / $46.77	Facility		$20.89	$20.89	$46.77
United Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $12.88 / $45.71	Professional		$12.59	$12.88	$45.71
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $20.89 / $20.89	Professional		$16.60	$20.89	$20.89