Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.42 / $52.48 / $165.96	Facility		$20.42	$52.48	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $27.54 / $125.89	Professional		$14.13	$27.54	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $36.31 / $45.71	Professional		$23.44	$36.31	$45.71
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $34.67 / $120.23	Professional		$19.05	$34.67	$120.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $24.55 / $58.88	Facility		$19.05	$24.55	$58.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $22.91 / $48.98	Professional		$11.48	$22.91	$48.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $23.44 / $24.55	Professional		$22.91	$23.44	$24.55
Midlands Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $23.44 / $23.44	Facility		$23.44	$23.44	$23.44
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $776.25 / $2,137.96	Facility		$67.61	$776.25	$2,137.96
United Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $19.05 / $41.69	Facility		$19.05	$19.05	$41.69
United Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $15.85 / $45.71	Professional		$11.48	$15.85	$45.71
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $19.05 / $19.05	Professional		$15.14	$19.05	$19.05